Provider Demographics
NPI:1336566033
Name:AUSTIN, SYDNEY LYNN (MHA, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:LYNN
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:MHA, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 BELLVIEW CT
Mailing Address - Street 2:
Mailing Address - City:RED LION
Mailing Address - State:PA
Mailing Address - Zip Code:17356-9079
Mailing Address - Country:US
Mailing Address - Phone:301-991-6537
Mailing Address - Fax:
Practice Address - Street 1:2319 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5009
Practice Address - Country:US
Practice Address - Phone:301-991-6537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00004962255A2300X
PART0048902255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer