Provider Demographics
NPI:1821381682
Name:SANCIO, RICHARD (LPN)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:SANCIO
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8647 164TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3450
Mailing Address - Country:US
Mailing Address - Phone:718-658-2448
Mailing Address - Fax:718-658-2449
Practice Address - Street 1:8647 164TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3450
Practice Address - Country:US
Practice Address - Phone:718-658-2448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10295339164W00000X
NY657959163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse