Healthcare Provider Details

I. General information

NPI: 1609571835
Provider Name (Legal Business Name): SYDNEY ANN MINOSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 OXFORD DR STE G200
BETHEL PARK PA
15102-4904
US

IV. Provider business mailing address

6422 UNION AVE
FINLEYVILLE PA
15332-1030
US

V. Phone/Fax

Practice location:
  • Phone: 412-851-8724
  • Fax: 412-851-8778
Mailing address:
  • Phone: 412-667-9798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP027188
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN660921
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: