Provider Demographics
NPI:1316458623
Name:SCHYDZIK, SANDRA THERESE
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:THERESE
Last Name:SCHYDZIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8168 WALKER DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-7310
Mailing Address - Country:US
Mailing Address - Phone:330-241-2992
Mailing Address - Fax:
Practice Address - Street 1:8168 WALKER DR
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-7310
Practice Address - Country:US
Practice Address - Phone:330-241-2992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-14
Last Update Date:2017-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH403736163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse