Provider Demographics
NPI:1336828441
Name:SADLER, JAMAL HUSAIN
Entity Type:Individual
Prefix:
First Name:JAMAL
Middle Name:HUSAIN
Last Name:SADLER
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 1:157 W KINGSBRIDGE RD APT 5C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2787
Mailing Address - Country:US
Mailing Address - Phone:914-327-1745
Mailing Address - Fax:
Practice Address - Street 1:509 WILLIS AVE FL 4A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-4001
Practice Address - Country:US
Practice Address - Phone:347-862-2034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP122737101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health