Provider Demographics
NPI:1760004469
Name:SARKIS, JOSEPH A
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
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 1:34 BLACKWELLS LNDG
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:CT
Mailing Address - Zip Code:06234-2444
Mailing Address - Country:US
Mailing Address - Phone:401-486-6199
Mailing Address - Fax:
Practice Address - Street 1:34 BLACKWELLS LNDG
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:CT
Practice Address - Zip Code:06234-2444
Practice Address - Country:US
Practice Address - Phone:401-486-6199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN254231363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care