Provider Demographics
NPI:1295071900
Name:SADAYA, JEFFREY
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:SADAYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 EASTERN PKWY
Mailing Address - Street 2:APT 7E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-4861
Mailing Address - Country:US
Mailing Address - Phone:516-680-9521
Mailing Address - Fax:
Practice Address - Street 1:341 EASTERN PKWY
Practice Address - Street 2:APT 7E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-4861
Practice Address - Country:US
Practice Address - Phone:516-680-9521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-27
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY028673OtherLICENSE