Provider Demographics
NPI:1710124813
Name:SABATINI PEDIATRICS PC
Entity Type:Organization
Organization Name:SABATINI PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SABATINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-275-3442
Mailing Address - Street 1:612 YALE PL
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-4611
Mailing Address - Country:US
Mailing Address - Phone:719-275-3442
Mailing Address - Fax:719-275-2306
Practice Address - Street 1:612 YALE PL
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-4611
Practice Address - Country:US
Practice Address - Phone:719-275-3442
Practice Address - Fax:719-275-2306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO063870261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO063870Medicare Oscar/Certification