Provider Demographics
NPI:1235322835
Name:SADAR PSYCHOLOGICAL AND SPORTS CENTER
Entity Type:Organization
Organization Name:SADAR PSYCHOLOGICAL AND SPORTS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELIKA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:SADAR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:610-933-9440
Mailing Address - Street 1:124 WOODLYN AVE
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:124 WOODLYN AVE
Practice Address - Street 2:
Practice Address - City:EAGLEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19403-1608
Practice Address - Country:US
Practice Address - Phone:610-933-9440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
084169Medicare PIN