Provider Demographics
NPI:1619255668
Name:SADYRIBEIRO PAIN MANAGEMENT AND MEDICAL SERVICES PC
Entity Type:Organization
Organization Name:SADYRIBEIRO PAIN MANAGEMENT AND MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:SADY
Authorized Official - Middle Name:THEODORO
Authorized Official - Last Name:RIBEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-743-7090
Mailing Address - Street 1:9525 JAMAICA AVE
Mailing Address - Street 2:WOODHAVEN
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-2282
Mailing Address - Country:US
Mailing Address - Phone:718-743-7090
Mailing Address - Fax:718-764-8202
Practice Address - Street 1:9525 JAMAICA AVE
Practice Address - Street 2:WOODHAVEN
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-2282
Practice Address - Country:US
Practice Address - Phone:718-743-7090
Practice Address - Fax:718-764-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-25
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4668207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty