Provider Demographics
NPI:1053657692
Name:TAYLOR, SYDNEY
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:TAYLOR
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 1:17321 CHAGRIN BLVD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-3744
Mailing Address - Country:US
Mailing Address - Phone:216-466-7602
Mailing Address - Fax:
Practice Address - Street 1:2890 VAN AKEN BLVD APT 312
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-2274
Practice Address - Country:US
Practice Address - Phone:216-394-8089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-01
Last Update Date:2019-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401101050610376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No376K00000XNursing Service Related ProvidersNurse's Aide