Provider Demographics
NPI:1013609775
Name:DIDONATO, SYDNEY NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:NICOLE
Last Name:DIDONATO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9722 WILLOW LEAF LN
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-9372
Mailing Address - Country:US
Mailing Address - Phone:704-754-2151
Mailing Address - Fax:
Practice Address - Street 1:5425 LANDMARK PL STE 105
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1951
Practice Address - Country:US
Practice Address - Phone:720-445-5698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0007938363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant