Provider Demographics
NPI:1508037557
Name:ISMAIL B. SENDI, MD PC
Entity Type:Organization
Organization Name:ISMAIL B. SENDI, MD PC
Other - Org Name:NEW OAKLAND CHILD-ADOLESCENT AND FAMILY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST. DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHIAPPACASSE
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:248-855-1540
Mailing Address - Street 1:6549 TOWN CENTER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-4824
Mailing Address - Country:US
Mailing Address - Phone:248-620-6400
Mailing Address - Fax:248-620-6405
Practice Address - Street 1:31500 SCHOOLCRAFT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1805
Practice Address - Country:US
Practice Address - Phone:734-422-9340
Practice Address - Fax:734-422-9353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1609882067Medicaid
0P38580Medicare PIN
234652Medicare Oscar/Certification