Provider Demographics
NPI:1992805097
Name:SADLER, IAN JOHN (PHD)
Entity type:Individual
Prefix:DR
First Name:IAN
Middle Name:JOHN
Last Name:SADLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 W 168TH ST
Mailing Address - Street 2:NEUROLOGICAL INSTITUTE-12TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3726
Mailing Address - Country:US
Mailing Address - Phone:212-305-9758
Mailing Address - Fax:212-342-1699
Practice Address - Street 1:710 W 168TH ST
Practice Address - Street 2:NEUROLOGICAL INSTITUTE-12TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3726
Practice Address - Country:US
Practice Address - Phone:212-305-9758
Practice Address - Fax:212-342-1699
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021935-1103TC0700X
AZ3854103TC0700X
FLPY6239103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical