Provider Demographics
NPI:1184128126
Name:FRAZIER, SADE DIAHANN (DO)
Entity type:Individual
Prefix:DR
First Name:SADE
Middle Name:DIAHANN
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2357
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-9157
Mailing Address - Country:US
Mailing Address - Phone:201-749-1996
Mailing Address - Fax:973-556-2054
Practice Address - Street 1:11 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3501
Practice Address - Country:US
Practice Address - Phone:908-386-5517
Practice Address - Fax:908-504-8042
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-23
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3095762084F0202X, 2084P0800X, 2084P0804X
NJ25MB112709002084F0202X, 2084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry