Provider Demographics
NPI:1669904207
Name:SYMS, ERIC ALYN (LPN)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:ALYN
Last Name:SYMS
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 1:3947 HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-2806
Mailing Address - Country:US
Mailing Address - Phone:716-361-2186
Mailing Address - Fax:
Practice Address - Street 1:3947 HARVARD ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-2806
Practice Address - Country:US
Practice Address - Phone:716-361-2186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-02
Last Update Date:2017-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308891-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse