1205066420 NPI number — NAEEM S SADAT P.A.

Table of content: NAEEM S SADAT P.A. (NPI 1205066420)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205066420 NPI number — NAEEM S SADAT P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SADAT
Provider First Name:
NAEEM
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.A.
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:
1205066420
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1981 MARCUS AVE
Provider Second Line Business Mailing Address:
SUITE 208
Provider Business Mailing Address City Name:
NEW HYDE PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11042-1038
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-670-1651
Provider Business Mailing Address Fax Number:
516-437-4167

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5645 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11355-5045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-670-1426
Provider Business Practice Location Address Fax Number:
516-437-4167
Provider Enumeration Date:
07/22/2009

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: 363A00000X , with the licence number:  013017 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00669 . This is a "MEDICARE GROUP NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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