Provider Demographics
NPI:1053208124
Name:SABINE, GRACE DELIA (PA-C)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:DELIA
Last Name:SABINE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 RADCLIFFE CT
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-1050
Mailing Address - Country:US
Mailing Address - Phone:732-861-7737
Mailing Address - Fax:
Practice Address - Street 1:620 DR CALVIN JONES HWY
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-3107
Practice Address - Country:US
Practice Address - Phone:919-761-5678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty