Healthcare Provider Details

I. General information

NPI: 1053685032
Provider Name (Legal Business Name): ALBERTA MARIE SYKES R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2012
Last Update Date: 03/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ESSEX DR
STATEN ISLAND NY
10314-7869
US

IV. Provider business mailing address

100 ESSEX DR
STATEN ISLAND NY
10314-7869
US

V. Phone/Fax

Practice location:
  • Phone: 718-370-6870
  • Fax: 718-370-6815
Mailing address:
  • Phone: 718-370-6870
  • Fax: 718-370-6815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number554116
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: