Provider Demographics
NPI:1336298942
Name:SABO, NAFTALI (MD)
Entity Type:Individual
Prefix:
First Name:NAFTALI
Middle Name:
Last Name:SABO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 HIGH SERVICE AVENUE
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-5115
Mailing Address - Country:US
Mailing Address - Phone:401-353-7370
Mailing Address - Fax:401-353-4385
Practice Address - Street 1:214 HIGH SERVICE AVENUE
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-5115
Practice Address - Country:US
Practice Address - Phone:401-353-7370
Practice Address - Fax:401-353-4385
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD6650207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI210238OtherRI BCBS
RI050499415OtherUNITED HEALTHCARE
RI200541OtherBLUE CHIP
RI050499415OtherUNITED HEALTHCARE
RI069000197Medicare ID - Type Unspecified