Kotredes, Sydney L
Kotredes, Sydney L is an individual health care provider with primary practice located at 6 Telcom Dr , Bangor ME 04401-3072. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Kotredes, Sydney L can be contacted via phone (207) 947-0147.Contact Information
Primary practice address
6 Telcom Dr
Bangor ME 04401-3072
Phone: (207) 947-0147
Fax: (207) 990-3365
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | CNP171091 | Maine |
Profile Details
| NPI number | 1922483973 |
|---|---|
| LBN Legal business name | Kotredes, Sydney L |
| Credentials | PNPC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2015 |
| Last updated | May 4th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922483973 | NPPES |
| New Jersey | MEDICAID | 0501557 | |
| New Jersey | MEDICAID | 103097936 | |
| New Jersey | MEDICAID | 6180051-00 |
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