Provider Demographics
NPI:1497074421
Name:DIGIACOMO-BAIN, SCHYLAR NICOLE
Entity Type:Individual
Prefix:MRS
First Name:SCHYLAR
Middle Name:NICOLE
Last Name:DIGIACOMO-BAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SCHYLAR
Other - Middle Name:NICOLE
Other - Last Name:DI GIACOMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9159 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-1931
Mailing Address - Country:US
Mailing Address - Phone:716-995-7455
Mailing Address - Fax:
Practice Address - Street 1:9159 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031-1931
Practice Address - Country:US
Practice Address - Phone:716-995-7455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist