Provider Demographics
NPI:1396026779
Name:SARDELLI, JAMES CHRISTIAN (RPA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CHRISTIAN
Last Name:SARDELLI
Suffix:
Gender:M
Credentials:RPA-C
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Mailing Address - Street 1:15 BARSTOW RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2211
Mailing Address - Country:US
Mailing Address - Phone:516-467-0510
Mailing Address - Fax:
Practice Address - Street 1:15 BARSTOW RD
Practice Address - Street 2:SUITE 105
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2211
Practice Address - Country:US
Practice Address - Phone:516-467-0510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY012458363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant