Provider Demographics
NPI:1790875631
Name:SADOSKI, CORINNE E (MD)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:E
Last Name:SADOSKI
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 1:43 OLD CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-3601
Mailing Address - Country:US
Mailing Address - Phone:978-287-3700
Mailing Address - Fax:
Practice Address - Street 1:133 OLD ROAD NINE ACRE CORNER
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4159
Practice Address - Country:US
Practice Address - Phone:978-287-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1513912085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3158748Medicaid
MAG35139Medicare UPIN
MA3158748Medicaid