MEDICARE: DR. DAVID M. SABO PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PS004474L	PA

General Provider Information

NPI Number	:	1235138264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID M. SABO PHD

Provider Business Mailing Address
First Line	:	200 N. 7TH STREET
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17046-5040
Country	:	US
Telephone Number	:	717-273-1710
Fax Number	:	717-273-1416

Provider Business Practice Location Address
First Line	:	200 N. 7TH STREET
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17046-5040
Country	:	US
Telephone Number	:	717-272-1653
Fax Number	:	717-272-4166

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	09/23/2008

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