Provider Demographics
NPI:1215392667
Name:SARKODIE, JULIET (MSED)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:
Last Name:SARKODIE
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 WALTON AVE APT 5D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-3454
Mailing Address - Country:US
Mailing Address - Phone:347-217-7827
Mailing Address - Fax:
Practice Address - Street 1:2075 WALTON AVE APT 5D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-3454
Practice Address - Country:US
Practice Address - Phone:347-217-7827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-29
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY622457121174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator