Organization
RUDOLPH M SADA, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUDOLPH MUNTU SADA M.D. (OWNER/PRACTITIONER)
(716) 434-0026
Entity
Organization
Contact information
Practice address
521 EAST AVE, LOCKPORT, NY 14094-3201
(716) 514-5853
(716) 434-6454
Mailing address
PO BOX 656, LOCKPORT, NY 14095-0656
(716) 434-0026
(716) 434-6454
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
Primary
120789
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010153901
UNIVERA
NY
01
—
000507174001
BC & BS OF WESTERN NY
NY
05
—
00362390
—
NY
01
—
4906609
INDEPENDENT HEALTH ASSOCI
NY
Enumeration date
08/25/2005
Last updated
08/22/2020
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