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General NPI Number Information
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NPI Number | 1407452006
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Entity Type | Organization
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Legal Business Name | VIDA SARKODIE INC.
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Dates
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Enumeration Date | 12/08/2020
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Last Update Date | 12/08/2020
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Provider Practice Location Address
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Address Line | 230 ROUTE 206 STE 3
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City | FLANDERS
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State | NJ
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Zip | 07836-9189
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Country | US
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Telephone | 973-298-0812
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Fax |
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Provider Business Mailing Address
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Address Line | 24 KENNEDY DR
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City | FLANDERS
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State | NJ
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Zip | 07836-9229
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Country | US
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Telephone | 862-596-0705
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | VIDA SARKODIE
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Credential | APN
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Telephone | 862-596-0705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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