Provider Demographics
NPI:1861360026
Name:ANTHONY, SPARKLE
Entity type:Individual
Prefix:
First Name:SPARKLE
Middle Name:
Last Name:ANTHONY
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 1:103 HENRY ST APT A
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-6557
Mailing Address - Country:US
Mailing Address - Phone:131-592-7400
Mailing Address - Fax:
Practice Address - Street 1:103 HENRY ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-6557
Practice Address - Country:US
Practice Address - Phone:315-927-4008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula