Provider Demographics
NPI:1326204124
Name:BECKER, SABRA (PA)
Entity Type:Individual
Prefix:
First Name:SABRA
Middle Name:
Last Name:BECKER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SABRA
Other - Middle Name:
Other - Last Name:RABINKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:538 LITCHFIELD ST
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-6669
Mailing Address - Country:US
Mailing Address - Phone:860-626-8232
Mailing Address - Fax:
Practice Address - Street 1:64 ROBBINS ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2613
Practice Address - Country:US
Practice Address - Phone:203-573-6263
Practice Address - Fax:203-573-6030
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002125363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical