Provider Demographics
NPI:1396815213
Name:SARKOS, SUSAN (APN-C, CRNFA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:SARKOS
Suffix:
Gender:F
Credentials:APN-C, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 434
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-0534
Mailing Address - Country:US
Mailing Address - Phone:973-957-0548
Mailing Address - Fax:866-395-0888
Practice Address - Street 1:7 EAST DR
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-2214
Practice Address - Country:US
Practice Address - Phone:973-957-0548
Practice Address - Fax:866-395-0888
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN08868500363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health