Provider Demographics
NPI:1154469195
Name:SARTORELLI, JENNIFER SONG-SUK CHO (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:SONG-SUK CHO
Last Name:SARTORELLI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:KAISER PERMANENTE MEDICARE ENROLLMENT
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:
Practice Address - Street 1:6111 EXECUTIVE BLVD
Practice Address - Street 2:KAISER PERMANENTE ROCKVILLE REGIONAL LAB
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3911
Practice Address - Country:US
Practice Address - Phone:301-255-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2021-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD32432207ZP0102X
MDD59057207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
016924K92Medicare ID - Type Unspecified
I30312Medicare UPIN