Healthcare Provider Details
I. General information
NPI: 1821452327
Provider Name (Legal Business Name): CHENEEN SYKES
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/11/2016
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3020 BAILEY AVE
BUFFALO NY
14215-2814
US
IV. Provider business mailing address
5904 SHERIDAN DR STE 1
WILLIAMSVILLE NY
14221-5873
US
V. Phone/Fax
- Phone: 716-831-2700
- Fax: 716-831-1818
- Phone: 716-886-5493
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 403066 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: