Provider Demographics
NPI:1174908297
Name:SADATIS, CHRISTAL THOMASINA (RN)
Entity type:Individual
Prefix:
First Name:CHRISTAL
Middle Name:THOMASINA
Last Name:SADATIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 FARADAY ST
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-3402
Mailing Address - Country:US
Mailing Address - Phone:617-947-9273
Mailing Address - Fax:
Practice Address - Street 1:22 FARADAY ST
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-3402
Practice Address - Country:US
Practice Address - Phone:617-947-9273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2266412163W00000X, 163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163W00000XNursing Service ProvidersRegistered Nurse