Provider Demographics
NPI:1942597380
Name:SINE, ERIC (NAVY IDC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:SINE
Suffix:
Gender:M
Credentials:NAVY IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 559 BOX 5256
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96377-5200
Mailing Address - Country:US
Mailing Address - Phone:01181801-385-7157
Mailing Address - Fax:
Practice Address - Street 1:3RD MARINE DIVISION
Practice Address - Street 2:UNIT 35801
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96602-5801
Practice Address - Country:US
Practice Address - Phone:01181611-722-9538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman