Healthcare Provider Details

I. General information

NPI: 1811992308
Provider Name (Legal Business Name): FREDERICK L SABIDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 RICHMOND ROAD SUITE 2A
STATEN ISLAND NY
10304-3623
US

IV. Provider business mailing address

1551 RICHMOND ROAD SUITE 2A
STATEN ISLAND NY
10304-2338
US

V. Phone/Fax

Practice location:
  • Phone: 718-442-4777
  • Fax: 718-273-6635
Mailing address:
  • Phone: 718-442-4777
  • Fax: 718-273-6635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number184145
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: