Provider Demographics
NPI:1447227707
Name:MIKITA, SABRINA KAY (MD)
Entity Type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:KAY
Last Name:MIKITA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SABRINA
Other - Middle Name:KAY
Other - Last Name:DOWD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1201 GRAMPIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-1900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1205 GRAMPIAN BLVD STE 1A
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-1968
Practice Address - Country:US
Practice Address - Phone:570-326-8060
Practice Address - Fax:570-326-8059
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD061041L207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1983424OtherUNITEDHEALTHCARE
PA133110OtherHIGHMARK BLUE SHIELD
PAG60288OtherHEALTHAMERICA
PA806010OtherFIRST PRIORITY HEALTH
PA5965625OtherAETNA
PA50054354OtherCAPITAL BLUE CROSS
PA0016781270008Medicaid
PA070012015Medicare PIN
PAG60288OtherHEALTHAMERICA
G60288Medicare UPIN