Provider Demographics
NPI:1891720900
Name:SORKIN, JONATHAN A (DPM)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:A
Last Name:SORKIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 NEWARK AVE STE 301B
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1348
Mailing Address - Country:US
Mailing Address - Phone:201-222-7888
Mailing Address - Fax:
Practice Address - Street 1:550 NEWARK AVE STE 301B
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1348
Practice Address - Country:US
Practice Address - Phone:201-222-7888
Practice Address - Fax:201-963-1775
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD001582213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT44524Medicare UPIN
NJ126151DPJMedicare UPIN