Provider Demographics
NPI:1003075110
Name:SADIKOT, SEAN SHABBIR (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:SHABBIR
Last Name:SADIKOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3600 ROUTE 66
Mailing Address - Street 2:FL 3
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-2645
Mailing Address - Country:US
Mailing Address - Phone:732-807-0800
Mailing Address - Fax:201-487-0461
Practice Address - Street 1:20 PROSPECT AVE STE 707
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1963
Practice Address - Country:US
Practice Address - Phone:551-996-2211
Practice Address - Fax:551-996-5727
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2020-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY248910207RP1001X
NJ25MA09282400207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ284878RKYMedicare UPIN