Provider Demographics
NPI:1740541713
Name:SYTNYK, EILEEN A (CRNP)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:A
Last Name:SYTNYK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 COTTAGE GROVE RD # A5HEA
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-2920
Mailing Address - Country:US
Mailing Address - Phone:860-226-4500
Mailing Address - Fax:
Practice Address - Street 1:900 COTTAGE GROVE RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2920
Practice Address - Country:US
Practice Address - Phone:860-226-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6568363LF0000X
IN71013303A363LF0000X
FLAPRN11030258363LF0000X
TN31670363LF0000X
PASP013972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily