Healthcare Provider Details

I. General information

NPI: 1558358689
Provider Name (Legal Business Name): MARC M SADOWSKY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 MERRIMACK ST
LAWRENCE MA
01843-1754
US

IV. Provider business mailing address

354 MERRIMACK ST
LAWRENCE MA
01843-1754
US

V. Phone/Fax

Practice location:
  • Phone: 978-687-2321
  • Fax: 978-685-7265
Mailing address:
  • Phone: 978-687-2321
  • Fax: 978-685-7265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number8176
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number75226
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number8176
License Number StateNH
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number75226
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: