Provider Demographics
NPI:1396204889
Name:SABO, LOUIS WILLIAM (LPN,)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:WILLIAM
Last Name:SABO
Suffix:
Gender:M
Credentials:LPN,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7136
Mailing Address - Country:US
Mailing Address - Phone:716-604-8856
Mailing Address - Fax:
Practice Address - Street 1:364 MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7136
Practice Address - Country:US
Practice Address - Phone:716-604-8856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY323620-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse