Provider Demographics
NPI:1720354749
Name:SYFOX, SHERWIN HAMILTON (LPN)
Entity type:Individual
Prefix:MR
First Name:SHERWIN
Middle Name:HAMILTON
Last Name:SYFOX
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7571 PATEO PASS DR
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-6031
Mailing Address - Country:US
Mailing Address - Phone:614-806-6654
Mailing Address - Fax:
Practice Address - Street 1:7571 PATEO PASS DR
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-6031
Practice Address - Country:US
Practice Address - Phone:614-806-6654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 134659164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse