Provider Demographics
NPI:1700236593
Name:SABATINO, MARY LAUREN (PNP)
Entity Type:Individual
Prefix:
First Name:MARY LAUREN
Middle Name:
Last Name:SABATINO
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:MARY LAUREN
Other - Middle Name:
Other - Last Name:MAGARGEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP
Mailing Address - Street 1:111 IVY DRIVE
Mailing Address - Street 2:APT 2
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903
Mailing Address - Country:US
Mailing Address - Phone:610-220-7148
Mailing Address - Fax:
Practice Address - Street 1:111 IVY DR
Practice Address - Street 2:APT 2
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-5012
Practice Address - Country:US
Practice Address - Phone:610-220-7148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-13
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY701859-1163W00000X
VA0001267841163W00000X
VA0024174591363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse