Provider Demographics
NPI:1104515295
Name:ALSADI, OMAR
Entity type:Individual
Prefix:MR
First Name:OMAR
Middle Name:
Last Name:ALSADI
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 1:13850 GUILD AVE
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7653
Mailing Address - Country:US
Mailing Address - Phone:612-443-4420
Mailing Address - Fax:
Practice Address - Street 1:13850 GUILD AVE
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7653
Practice Address - Country:US
Practice Address - Phone:612-443-4420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool