Provider Demographics
NPI:1134957418
Name:SADI PA, P.C.
Entity type:Organization
Organization Name:SADI PA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:R PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-981-7314
Mailing Address - Street 1:1003 W BALTIMORE PIKE
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1003 W BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5135
Practice Address - Country:US
Practice Address - Phone:484-444-2793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SADI PA, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental