Basic Information
| Provider Information | |||||||||
| NPI: | 1962407619 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SADOWSKY | ||||||||
| FirstName: | GABRIELLE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 BRICKELL AVE | ||||||||
| Address2: | SUITE: 401 - NORTH TOWER | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331313105 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2702 N 3RD ST | ||||||||
| Address2: | STE 1014 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850041130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022790003 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2005 | ||||||||
| LastUpdateDate: | 06/08/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | DA1350 | AZ | N | Speech, Language and Hearing Service Providers | Audiologist | 237600000X | DA1350 | AZ | Y | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 231H00000X | 5965 | NM | N | Speech, Language and Hearing Service Providers | Audiologist | 237600000X | 5965 | NM | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
ID Information
| ID | Type | State | Issuer | Description | 640004720 | 01 | AZ | RAILROAD MEDICARE | OTHER | 621921 | 05 | AZ | MEDICAID | 01089518 | 01 | AZ | ASHA CERTIFICATION | OTHER | AZ0901110 | 01 | AZ | BLUE CROSS BLUE SHIELD OF ARIZONA | OTHER | DA1350 | 01 | AZ | STATE LICENSE | OTHER |