Provider Demographics
NPI:1184676728
Name:SADY MEDICAL ENTERPRISES, INC.
Entity type:Organization
Organization Name:SADY MEDICAL ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN'S ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SADY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:702-693-6222
Mailing Address - Street 1:4161 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5483
Mailing Address - Country:US
Mailing Address - Phone:702-693-6222
Mailing Address - Fax:702-369-6504
Practice Address - Street 1:4161 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5484
Practice Address - Country:US
Practice Address - Phone:702-693-6222
Practice Address - Fax:702-369-6504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV576363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty