Provider Demographics
NPI:1407967177
Name:SARRIS, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SARRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6425
Mailing Address - Country:US
Mailing Address - Phone:732-341-1881
Mailing Address - Fax:732-505-4453
Practice Address - Street 1:9 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6425
Practice Address - Country:US
Practice Address - Phone:732-341-1881
Practice Address - Fax:732-505-4453
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05927000207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG42452Medicare UPIN