Provider Demographics
NPI:1245211309
Name:FEFER-SADLER, SANDRA MYRIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:MYRIAM
Last Name:FEFER-SADLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SAYMOR DR
Mailing Address - Street 2:
Mailing Address - City:BARDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2152
Mailing Address - Country:US
Mailing Address - Phone:845-624-3571
Mailing Address - Fax:
Practice Address - Street 1:26 NEW MAIN ST
Practice Address - Street 2:SANDRA SADLER PEDIATRICS
Practice Address - City:HAVERSTRAW
Practice Address - State:NY
Practice Address - Zip Code:10927-1810
Practice Address - Country:US
Practice Address - Phone:845-786-0000
Practice Address - Fax:866-520-3592
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207382-12080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY227OtherHUDSON HEALTH PLAN
NY132632069OtherBUSINESS NPI
NY232ZA1OtherEMPIRE BC AND BS
NY01771791Medicaid
NY01771791Medicaid