Provider Demographics
NPI:1407290802
Name:DIEHL, SABRINA L (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:L
Last Name:DIEHL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:SABRINA
Other - Middle Name:L
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:11 GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:SOUND BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11789-1624
Mailing Address - Country:US
Mailing Address - Phone:631-258-8120
Mailing Address - Fax:
Practice Address - Street 1:100 HOSPITAL RD
Practice Address - Street 2:STE. 115
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-8809
Practice Address - Country:US
Practice Address - Phone:631-687-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302922/ 1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse