Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 000000 | CT |
NPI | 1073171393 |
---|---|
Provider Name | Sabine Donato Dabady |
First Address | Waterbury, CT 06705-2407 |
Second Address | Waterbury, CT 06705-2407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2019 |
Last Update Date | 01/06/2019 |