Basic Information
Provider Information | |||||||||
NPI: | 1780881029 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SABIA | ||||||||
FirstName: | MICHAEL | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1 FEDERAL ST STE SW200 | ||||||||
Address2: |   | ||||||||
City: | CAMDEN | ||||||||
State: | NJ | ||||||||
PostalCode: | 081031155 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8563564924 | ||||||||
FaxNumber: | 8563564710 | ||||||||
Practice Location | |||||||||
Address1: | 900 CENTENNIAL BLVD | ||||||||
Address2: | BLDG 1, SUITES E & G | ||||||||
City: | VOORHEES | ||||||||
State: | NJ | ||||||||
PostalCode: | 08043 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8563256535 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/29/2007 | ||||||||
LastUpdateDate: | 01/02/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 01/02/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | 25MA07992600 | NJ | Y |   | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
ID | Type | State | Issuer | Description | 1597933 | 01 | NJ | AETNA | OTHER | 60033613 | 01 | NJ | HORIZON NJ HEALTH | OTHER | P3807813 | 01 | NJ | OXFORD | OTHER | 010078330 | 01 | NJ | AMERICHOICE | OTHER | 60033612 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 2862004000 | 01 | NJ | AMERIHEALTH/KEYSTONE/IBC | OTHER | 0136191 | 05 | NJ |   | MEDICAID | 1598074 | 01 | NJ | AETNA | OTHER | 2802732 | 01 | NJ | UNITED HEALTHCARE | OTHER | 0654536 | 01 | NJ | CIGNA | OTHER |