Provider Demographics
NPI:1124156161
Name:SABET, VIRGINIA
Entity type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:
Last Name:SABET
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:VIRGINIA
Other - Middle Name:
Other - Last Name:YO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:333 ELM ST STE 220
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-4530
Mailing Address - Country:US
Mailing Address - Phone:781-329-7311
Mailing Address - Fax:
Practice Address - Street 1:333 ELM ST STE 220
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-4530
Practice Address - Country:US
Practice Address - Phone:781-329-7311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA240642207R00000X
MDDOO61265207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110083041AMedicaid
MD56-2508917OtherTAX ID #