Provider Demographics
NPI:1205885340
Name:SADOWSKI, KEVIN E (MSN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:E
Last Name:SADOWSKI
Suffix:
Gender:M
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 HAZARD AVE
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-4521
Mailing Address - Country:US
Mailing Address - Phone:860-763-2225
Mailing Address - Fax:860-763-3161
Practice Address - Street 1:143 HAZARD AVE
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-4521
Practice Address - Country:US
Practice Address - Phone:860-763-2225
Practice Address - Fax:860-763-3161
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6454363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT05-0001310CT04OtherANTHEM BC/BS
CT88001310OtherCIGNA
CTP2994214OtherOXFORD
CT004198348Medicaid
CT3283032OtherAETNA
CT1949968OtherUNITED HEALTH CARE
CTU84014Medicare UPIN
CT004198348Medicaid