Provider Demographics
NPI:1649510629
Name:SABATER, LUIS SR (PA)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:SABATER
Suffix:SR
Gender:M
Credentials:PA
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:85 8TH AVE APT 3K
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-5123
Mailing Address - Country:US
Mailing Address - Phone:917-494-1128
Mailing Address - Fax:
Practice Address - Street 1:1 BROOKDALE PLAZA
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212
Practice Address - Country:US
Practice Address - Phone:718-240-6899
Practice Address - Fax:718-240-6655
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY016351-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant