Provider Demographics
NPI:1467651257
Name:SABATINO, GREGORY JOHN (DC)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:JOHN
Last Name:SABATINO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 NEW HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4854
Mailing Address - Country:US
Mailing Address - Phone:203-212-7717
Mailing Address - Fax:203-283-5658
Practice Address - Street 1:75 NEW HAVEN AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4854
Practice Address - Country:US
Practice Address - Phone:203-212-7717
Practice Address - Fax:203-283-5658
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001034111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004131710Medicaid
CT350000780Medicare UPIN