Healthcare Provider Details

I. General information

NPI: 1336188986
Provider Name (Legal Business Name): RICHARD SYKE F.N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ATWELL RD
COOPERSTOWN NY
13326-1301
US

IV. Provider business mailing address

PO BOX 725
COOPERSTOWN NY
13326-0725
US

V. Phone/Fax

Practice location:
  • Phone: 607-965-8900
  • Fax: 607-965-8631
Mailing address:
  • Phone: 607-965-8900
  • Fax: 607-965-8631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF330566
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: