Healthcare Provider Details

I. General information

NPI: 1073146619
Provider Name (Legal Business Name): EMILY SYKOLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2020
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 STATE ST
ERIE PA
16550-0002
US

IV. Provider business mailing address

5519 STONE RUN DR
FAIRVIEW PA
16415-3227
US

V. Phone/Fax

Practice location:
  • Phone: 814-877-6000
  • Fax:
Mailing address:
  • Phone: 814-806-5183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN615684
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: