Provider Demographics
NPI:1619992963
Name:SABELLA, JENNIFER (OCCUPATIONAL THERAP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SABELLA
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 RIDGEVIEW PL
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-1720
Mailing Address - Country:US
Mailing Address - Phone:631-747-7677
Mailing Address - Fax:631-331-2392
Practice Address - Street 1:635 BELLE TERRE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-1935
Practice Address - Country:US
Practice Address - Phone:631-331-3608
Practice Address - Fax:631-331-2392
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009726-1225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQV1371OtherEMPIRE BLUE CROSS BLUE SHIELD
NY1619992963Medicare PIN