Healthcare Provider Details

I. General information

NPI: 1306158738
Provider Name (Legal Business Name): KYRIAKI SANDY DALARIS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2010
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 EGG HARBOR RD
SEWELL NJ
08080-1854
US

IV. Provider business mailing address

300 EGG HARBOR RD
SEWELL NJ
08080-1854
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax: 401-216-2854
Mailing address:
  • Phone: 866-389-2727
  • Fax: 401-216-2854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number356787
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN689403
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP031858
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR12768300
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number974988
License Number StateNY
# 6
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00293400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: