Provider Demographics
NPI:1992971469
Name:SANKIN, GENE (MD)
Entity type:Individual
Prefix:
First Name:GENE
Middle Name:
Last Name:SANKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 NEWARK AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-2347
Mailing Address - Country:US
Mailing Address - Phone:201-533-0055
Mailing Address - Fax:
Practice Address - Street 1:82 ADMIRALTY LOOP
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-3961
Practice Address - Country:US
Practice Address - Phone:917-704-7152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09607200207R00000X, 207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine