Provider Demographics
NPI:1578989554
Name:SARKIS, FADI
Entity Type:Individual
Prefix:DR
First Name:FADI
Middle Name:
Last Name:SARKIS
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 1:53 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3314
Mailing Address - Country:US
Mailing Address - Phone:973-246-9355
Mailing Address - Fax:
Practice Address - Street 1:716 BROAD ST
Practice Address - Street 2:SUITE 1E
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013
Practice Address - Country:US
Practice Address - Phone:973-246-9355
Practice Address - Fax:973-246-9356
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-13
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00715400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor