Provider Demographics
NPI:1790009371
Name:SADOWSKI, MARTIN (RPH)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:SADOWSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6298 SAUNDERS ST
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1566
Mailing Address - Country:US
Mailing Address - Phone:718-896-3732
Mailing Address - Fax:
Practice Address - Street 1:14401 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-3645
Practice Address - Country:US
Practice Address - Phone:718-530-9022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist