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NPI Code Detail

MEDICARE: MS. JESSICA SARKIS P.A.

MEDICARE: MS. JESSICA SARKIS P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant50.004538OH

General Provider Information

NPI Number : 1255796124
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JESSICA SARKIS P.A.
Provider Business Mailing Address
First Line : 1289 WARREN RD
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-2515
Country : US
Telephone Number : 216-316-0673
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-445-1905
Fax Number : 216-445-4552
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2015
Last Update Date : 12/20/2015

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