MEDICARE: DR. PHYLLIS JANE SABOL 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	207RH0000X	Hematology (Internal Medicine) Physician	TD061013	ME
2	207RH0003X	Hematology & Oncology Physician	MD023145E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	823094	OTHER	PA	FIRST PRIORITY HEALTH
2	714108	OTHER	PA	HIGHMARK BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730126582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHYLLIS JANE SABOL MD

Provider Business Mailing Address
First Line	:	1846 ARTHUR ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152
Country	:	US
Telephone Number	:	267-357-3724
Fax Number	:

Provider Business Practice Location Address
First Line	:	1856 ARTHUR ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152
Country	:	US
Telephone Number	:	267-357-3724
Fax Number	:

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	08/26/2008

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