| Jessy Sadovnik Pa | |
|
765 Ne 195th St Miami FL 33179-3421 | |
| (305) 632-0630 | |
| Not Available |
| Full Name | Jessy Sadovnik Pa |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 765 Ne 195th St, Miami, Florida |
| Authorized Official Name and Position | Jessy Sadovnik (PRESIDENT) |
| Authorized Official Contact | 3056320630 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jessy Sadovnik Pa 765 Ne 195th St Miami FL 33179-3421 Ph: (305) 632-0630 | Jessy Sadovnik Pa 765 Ne 195th St Miami FL 33179-3421 Ph: (305) 632-0630 |
| NPI Number | 1124204979 |
|---|---|
| Provider Enumeration Date | 01/10/2008 |
| Last Update Date | 04/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124204979 | NPI | - | NPPES |
| U0561 | Other | PTAN | |
| AH119 | Other | FL | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY6670 (Florida) | Primary |
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