Provider Demographics
NPI:1861520173
Name:DR. SAFADI & ASSOCIATES, INC
Entity type:Organization
Organization Name:DR. SAFADI & ASSOCIATES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GHASSAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAFADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-843-7780
Mailing Address - Street 1:PO BOX 352108
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43635-2108
Mailing Address - Country:US
Mailing Address - Phone:419-843-7780
Mailing Address - Fax:419-715-1377
Practice Address - Street 1:7640 SYLVANIA AVE
Practice Address - Street 2:J
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-9729
Practice Address - Country:US
Practice Address - Phone:419-843-7780
Practice Address - Fax:419-715-1377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35062753207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2832322Medicaid
OHDE1471OtherRAILROAD MEDICARE ID
OH9340602Medicare PIN