Provider Demographics
NPI:1386713543
Name:SABREE, EVERETT B (OD)
Entity type:Individual
Prefix:DR
First Name:EVERETT
Middle Name:B
Last Name:SABREE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 DARTMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-5118
Mailing Address - Country:US
Mailing Address - Phone:617-266-8188
Mailing Address - Fax:617-266-0324
Practice Address - Street 1:130 DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-5118
Practice Address - Country:US
Practice Address - Phone:617-266-8188
Practice Address - Fax:617-266-0324
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2972152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9759026Medicaid
MA08185Medicare UPIN
MA9759026Medicaid