Provider Demographics
NPI:1881237246
Name:SABOURNIN, ANA MARIA (APRNCB)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:MARIA
Last Name:SABOURNIN
Suffix:
Gender:F
Credentials:APRNCB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 W 168TH ST FL 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3726
Mailing Address - Country:US
Mailing Address - Phone:212-305-1710
Mailing Address - Fax:718-563-4039
Practice Address - Street 1:710 W 168TH ST FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3726
Practice Address - Country:US
Practice Address - Phone:212-305-1710
Practice Address - Fax:212-305-1658
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-17
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF345380363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty