Provider Demographics
NPI:1003876202
Name:SARTORI, ROY JOHN (DO)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:JOHN
Last Name:SARTORI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 EASTLAND AVE SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-4503
Mailing Address - Country:US
Mailing Address - Phone:330-841-2378
Mailing Address - Fax:330-841-4667
Practice Address - Street 1:667 EASTLAND AVE SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-4503
Practice Address - Country:US
Practice Address - Phone:330-841-2378
Practice Address - Fax:330-841-4667
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004082L207P00000X
PAOS004082-L207R00000X
OH34-002622208M00000X
OH2622207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100748346Medicaid
PA0007119980005Medicaid
OH0433374Medicaid
PA100748346Medicaid
PAB40276Medicare UPIN