Provider Demographics
NPI:1881140168
Name:ODAI, SARAI H (NP)
Entity type:Individual
Prefix:
First Name:SARAI
Middle Name:H
Last Name:ODAI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SARAI
Other - Middle Name:S
Other - Last Name:HUITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:601 EMLWOOD AVE BOX MED
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-486-0930
Mailing Address - Fax:
Practice Address - Street 1:400 RED CREEK DR STE 220
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4281
Practice Address - Country:US
Practice Address - Phone:585-486-0930
Practice Address - Fax:585-340-5399
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340185363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04545268Medicaid
NYJ400329273-GRPBA0017Medicare PIN
NYJ400329258-GRP70008AMedicare PIN