Provider Demographics
NPI:1104803535
Name:SADEK, NOHA (MD)
Entity type:Individual
Prefix:
First Name:NOHA
Middle Name:
Last Name:SADEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 VETERANS MEMORIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-5061
Mailing Address - Country:US
Mailing Address - Phone:401-432-1000
Mailing Address - Fax:
Practice Address - Street 1:1011 VETERANS MEMORIAL PKWY
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-5061
Practice Address - Country:US
Practice Address - Phone:401-432-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2305102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP35437OtherHEALTHPARTNERS
MN072M1SAMedicaid
MNMH9041030861OtherPREFERREDONE
MN142054Medicaid
MN1621116OtherARAZ
IA552539Medicaid
MN63377100Medicaid
MN7764OtherAVERA
MN072M1SAOtherBLUE CROSS
MNA058OtherCHAMPUS
MN7764OtherAVERA
MNA058OtherCHAMPUS
MN63377100Medicaid
MNHP35437OtherHEALTHPARTNERS
MNMH9041030861OtherPREFERREDONE