Provider Demographics
NPI:1316603855
Name:PTAK, SHEILA M (NP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:M
Last Name:PTAK
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:251 SALINA MEADOWS PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212
Mailing Address - Country:US
Mailing Address - Phone:315-464-2000
Mailing Address - Fax:315-464-2010
Practice Address - Street 1:750 EAST ADAMS STREET
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-6334
Practice Address - Fax:315-464-3693
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2024-01-16
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Provider Licenses
StateLicense IDTaxonomies
NY383311363L00000X, 363LP0200X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics