Provider Demographics
NPI:1942200035
Name:SABO, KATHRYN A (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:A
Last Name:SABO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CARE LN
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-8639
Mailing Address - Country:US
Mailing Address - Phone:518-682-2240
Mailing Address - Fax:518-682-2243
Practice Address - Street 1:3 CARE LN
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-8639
Practice Address - Country:US
Practice Address - Phone:518-682-2240
Practice Address - Fax:518-682-2243
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003352363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00630039Medicaid
NYR55802Medicare UPIN