Provider Demographics
NPI:1336268614
Name:SISK, NASRIN SOROCK (MD)
Entity type:Individual
Prefix:DR
First Name:NASRIN
Middle Name:SOROCK
Last Name:SISK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 VARNUM ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2145
Mailing Address - Country:US
Mailing Address - Phone:202-269-7430
Mailing Address - Fax:202-269-7328
Practice Address - Street 1:430 COVE TOWER DR APT 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-6087
Practice Address - Country:US
Practice Address - Phone:240-644-7551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME152188207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine