Provider Demographics
NPI:1821380163
Name:SINCLAIR, BRIDGETTE MARCIA
Entity Type:Individual
Prefix:MS
First Name:BRIDGETTE
Middle Name:MARCIA
Last Name:SINCLAIR
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 1:53 DUNBAR ST
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-1527
Mailing Address - Country:US
Mailing Address - Phone:631-671-7966
Mailing Address - Fax:
Practice Address - Street 1:53 DUNBAR ST
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-1527
Practice Address - Country:US
Practice Address - Phone:631-671-7966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236122-1164W00000X
NY821751163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse