Provider Demographics
NPI:1770858912
Name:SABIN, RENETTE (471621-1)
Entity Type:Individual
Prefix:MS
First Name:RENETTE
Middle Name:
Last Name:SABIN
Suffix:
Gender:F
Credentials:471621-1
Other - Prefix:MS
Other - First Name:RENETTE
Other - Middle Name:
Other - Last Name:SABIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:6943442
Mailing Address - Street 1:16565 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1936
Mailing Address - Country:US
Mailing Address - Phone:718-297-6580
Mailing Address - Fax:718-658-0365
Practice Address - Street 1:16565 84TH AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1936
Practice Address - Country:US
Practice Address - Phone:718-297-6580
Practice Address - Fax:718-658-0365
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY471621-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse