Provider Demographics
NPI:1679684583
Name:SADECKI, CHRISTINE N (OTR)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:N
Last Name:SADECKI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7759 CEDAR HURST CT
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7879
Mailing Address - Country:US
Mailing Address - Phone:561-385-8109
Mailing Address - Fax:561-433-9543
Practice Address - Street 1:7759 CEDAR HURST CT
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-7879
Practice Address - Country:US
Practice Address - Phone:561-385-8109
Practice Address - Fax:561-433-9543
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 9909225XP0200X
FLOT9909222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL886489600Medicaid