Basic Information
| Provider Information | |||||||||
| NPI: | 1619255668 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SADYRIBEIRO PAIN MANAGEMENT AND MEDICAL SERVICES PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9525 JAMAICA AVE | ||||||||
| Address2: | WOODHAVEN | ||||||||
| City: | WOODHAVEN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114212282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187437090 | ||||||||
| FaxNumber: | 7187648202 | ||||||||
| Practice Location | |||||||||
| Address1: | 9525 JAMAICA AVE | ||||||||
| Address2: | WOODHAVEN | ||||||||
| City: | WOODHAVEN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114212282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187437090 | ||||||||
| FaxNumber: | 7187648202 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2011 | ||||||||
| LastUpdateDate: | 02/12/2013 | ||||||||
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| AuthorizedOfficialLastName: | RIBEIRO | ||||||||
| AuthorizedOfficialFirstName: | SADY | ||||||||
| AuthorizedOfficialMiddleName: | THEODORO | ||||||||
| AuthorizedOfficialTitleorPosition: | ANESTHESIOLOGY | ||||||||
| AuthorizedOfficialTelephone: | 7187437090 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | J4668 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.