Provider Demographics
NPI:1215720669
Name:SABASTRO, OWEN
Entity type:Individual
Prefix:
First Name:OWEN
Middle Name:
Last Name:SABASTRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2986 SEISHOLTZVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-8537
Mailing Address - Country:US
Mailing Address - Phone:267-372-1196
Mailing Address - Fax:
Practice Address - Street 1:2986 SEISHOLTZVILLE RD
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-8537
Practice Address - Country:US
Practice Address - Phone:267-372-1196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty