1609968270 NPI number — DR. ANNMARIE D SABOVIK DO

Table of content: DR. ANNMARIE D SABOVIK DO (NPI 1609968270)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609968270 NPI number — DR. ANNMARIE D SABOVIK DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SABOVIK
Provider First Name:
ANNMARIE
Provider Middle Name:
D
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609968270
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/11/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 NORTHPOINTE CIR
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
SEVEN FIELDS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16046-7851
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-772-0777
Provider Business Mailing Address Fax Number:
724-772-0050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 NORTHPOINTE CIR
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
SEVEN FIELDS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16046-7851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-772-0777
Provider Business Practice Location Address Fax Number:
724-772-0050
Provider Enumeration Date:
09/29/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  OS013091 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1013019140001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".