Provider Demographics
NPI:1275634636
Name:PORCARO, SABINA MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:SABINA
Middle Name:MARY
Last Name:PORCARO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 N 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5950
Mailing Address - Country:US
Mailing Address - Phone:973-743-3313
Mailing Address - Fax:973-743-1136
Practice Address - Street 1:228 N 15TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-5950
Practice Address - Country:US
Practice Address - Phone:973-743-3313
Practice Address - Fax:973-743-1136
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA04871800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPO536520Medicare ID - Type Unspecified
NJC56913Medicare UPIN