Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | C1-0023816 | DE |
NPI | 1013207117 |
---|---|
Provider Name | Jonathan R Sarik |
First Address | Dover, DE 19901-3530 |
Second Address | Milford, DE 19963-4366 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2011 |
Last Update Date | 09/11/2021 |