Provider Demographics
NPI:1831291715
Name:SABATELLI, RAYMOND F JR (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:F
Last Name:SABATELLI
Suffix:JR
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 1:29 LEWIS AVE
Mailing Address - Street 2:FAIRVIEW HOSPITAL EMERGENCY DEPT.
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1713
Mailing Address - Country:US
Mailing Address - Phone:413-854-9638
Mailing Address - Fax:413-854-9639
Practice Address - Street 1:29 LEWIS AVE
Practice Address - Street 2:FAIRVIEW HOSPITAL EMERGENCY DEPT.
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1713
Practice Address - Country:US
Practice Address - Phone:413-854-9638
Practice Address - Fax:413-854-9639
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA33381207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA33381OtherCDPHP
B96320Medicare UPIN
MA33381OtherCDPHP