Provider Demographics
NPI:1619081296
Name:SARKAS, JENNIFER (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:SARKAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:SARKAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:845 N MAIN ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-5700
Mailing Address - Country:US
Mailing Address - Phone:401-351-8960
Mailing Address - Fax:401-351-8962
Practice Address - Street 1:845 N MAIN ST
Practice Address - Street 2:SUITE 8
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-5700
Practice Address - Country:US
Practice Address - Phone:401-351-8960
Practice Address - Fax:401-351-8962
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00463111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor