MEDICARE: DR. NURIA ALICIA SABATE MD

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	2084P0800X	Psychiatry Physician	11306	PR
2	2084P0804X	Child & Adolescent Psychiatry Physician	11306	PR

General Provider Information

NPI Number	:	1720275985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NURIA ALICIA SABATE MD

Provider Business Mailing Address
First Line	:	30 CALLE WASHINGTON
Second Line	:	APT 12 N
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1589
Country	:	US
Telephone Number	:	787-723-6907
Fax Number	:

Provider Business Practice Location Address
First Line	:	1452 ASHFORD
Second Line	:	SUITE 5
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1581
Country	:	US
Telephone Number	:	787-723-6907
Fax Number	:

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

Provider Enumeration Date	:	10/01/2007
Last Update Date	:	10/01/2007

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