1558358689 NPI number — DR. MARC M SADOWSKY M.D.

Table of content: DR. MARC M SADOWSKY M.D. (NPI 1558358689)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558358689 NPI number — DR. MARC M SADOWSKY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SADOWSKY
Provider First Name:
MARC
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558358689
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
354 MERRIMACK ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01843-1754
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-687-2321
Provider Business Mailing Address Fax Number:
978-685-7265

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
354 MERRIMACK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01843-1754
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-687-2321
Provider Business Practice Location Address Fax Number:
978-685-7265
Provider Enumeration Date:
10/04/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  8176 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0805X , with the licence number: 75226 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0805X , with the licence number: 8176 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: 75226 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0106679Y0NH01 . This is a "ANTHEM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: J12074 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 079478000 . This is a "MAGELLAN FOR BCBSMA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 101854 . This is a "MAGELLAN BEHAVIORAL HEALT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1169401 . This is a "FIRST HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 99620 . This is a "CIGNA BEHAVIORAL HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 015769 . This is a "VALUEOPTIONS FOR OPTIONS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 15-90547 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 30003553 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4274226 . This is a "MAGELLAN FOR AETNA MBRS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 68499 . This is a "VALUE BEHAVIORAL HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: S017593 . This is a "CHAMPUS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000834 . This is a "VALUEOPTIONS FOR HPHC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 075226 . This is a "THP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com