Provider Demographics
NPI:1487484804
Name:SINO, EILEEN RITA
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:RITA
Last Name:SINO
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 1:38 MOHAWK AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ATLANTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-1013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:38 MOHAWK AVE
Practice Address - Street 2:
Practice Address - City:EAST ATLANTIC BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-1013
Practice Address - Country:US
Practice Address - Phone:516-554-3696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY461564163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse