=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346425444
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INFECTIOUS DISEASES CONSULTANTS OF GREENWICH PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2008
-----------------------------------------------------
Last Update Date | 01/08/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5 PERRYRIDGE RD
-----------------------------------------------------
City | GREENWICH
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06830-4608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-863-3270
-----------------------------------------------------
Fax | 203-863-3262
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5 PERRYRIDGE RD
-----------------------------------------------------
City | GREENWICH
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06830-4608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-863-3270
-----------------------------------------------------
Fax | 203-863-3262
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER
-----------------------------------------------------
Name | DR. JAMES R SABETTA
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 203-863-3270
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RI0200X
-----------------------------------------------------
Taxonomy Name | Infectious Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------