Basic Information
Provider Information
NPI: 1487821468
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SADIKOVIC
FirstName: AZRA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1650 GRAND CONCOURSE
Address2: 5TH FLOOR DEPT. OF OB/GYN
City: BRONX
State: NY
PostalCode: 104577606
CountryCode: US
TelephoneNumber: 7182398383
FaxNumber:  
Practice Location
Address1: 1650 GRAND CONCOURSE
Address2: 5TH FLOOR DEPT. OF OB/GYN
City: BRONX
State: NY
PostalCode: 104577606
CountryCode: US
TelephoneNumber: 7182398383
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/09/2008
LastUpdateDate: 02/27/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X036128491ILY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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