Individual
NICOLE SYRISTATIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
174 DRAKE LN, LEDGEWOOD, NJ 07852-9688
(908) 370-8289
Mailing address
174 DRAKE LN, LEDGEWOOD, NJ 07852-9688
(908) 370-8289
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0450266244
RESPITE CARE LLC
NJ
Enumeration date
05/14/2018
Last updated
05/14/2018
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