Provider Demographics
NPI:1922065150
Name:SADOWITZ, PETER DAVID (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:DAVID
Last Name:SADOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:P.
Other - Middle Name:DAVID
Other - Last Name:SADOWITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:750 E ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2306
Mailing Address - Country:US
Mailing Address - Phone:315-464-4363
Mailing Address - Fax:315-464-6229
Practice Address - Street 1:750 E ADAMS ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2306
Practice Address - Country:US
Practice Address - Phone:315-464-4363
Practice Address - Fax:315-464-6229
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1451932080P0207X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00821027Medicaid
NY00821027Medicaid
NYJ400034454Medicare PIN