Provider Demographics
NPI:1699738575
Name:PASSEY, SAHDEV R (MD)
Entity type:Individual
Prefix:DR
First Name:SAHDEV
Middle Name:R
Last Name:PASSEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 HARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-2520
Mailing Address - Country:US
Mailing Address - Phone:508-829-5884
Mailing Address - Fax:
Practice Address - Street 1:10 WINTHROP ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-4435
Practice Address - Country:US
Practice Address - Phone:508-753-3120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59070208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA200401OtherPILGRIM
MA2059622Medicaid
MA91115OtherFALLON
MAN01752OtherBLUE CROSS BLUE SHIELD
MA0075621OtherAETNA
MA059070OtherTUFTS
MA997082OtherNETWORK HEALTH
MA350440OtherCIGNA
MA2059622Medicaid