Provider Demographics
NPI:1669508057
Name:SABETTA, JAMES ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:SABETTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PERRYRIDGE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-4608
Mailing Address - Country:US
Mailing Address - Phone:203-863-3271
Mailing Address - Fax:203-868-3262
Practice Address - Street 1:5 PERRYRIDGE RD
Practice Address - Street 2:SUITE 108
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-4608
Practice Address - Country:US
Practice Address - Phone:203-863-3271
Practice Address - Fax:203-868-3262
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT024629174400000X
RIMD05796174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010024629 CT01OtherANTHEM BLUE CROSS
CT645418OtherUNITED HEALTH CARE
CT6518344-005OtherCIGNA
CTP1982939OtherOXFORD
CT763995OtherCONNECTICARE
CT2271148OtherAETNA
CT6518344-005OtherCIGNA