Provider Demographics
NPI:1841211422
Name:SADICK, NEIL SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:SCOTT
Last Name:SADICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 PARK AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-0337
Mailing Address - Country:US
Mailing Address - Phone:212-772-7242
Mailing Address - Fax:
Practice Address - Street 1:911 PARK AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-0337
Practice Address - Country:US
Practice Address - Phone:212-772-7242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY134797207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY74A422Medicare ID - Type Unspecified
NYA62605Medicare UPIN
NY74A421Medicare ID - Type Unspecified