Provider Demographics
NPI:1043965189
Name:SITLER, ERIC LEE (RN)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:LEE
Last Name:SITLER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 NEW YORK CT
Mailing Address - Street 2:
Mailing Address - City:REXFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12148-1350
Mailing Address - Country:US
Mailing Address - Phone:518-429-8717
Mailing Address - Fax:
Practice Address - Street 1:2 NEW YORK CT
Practice Address - Street 2:
Practice Address - City:REXFORD
Practice Address - State:NY
Practice Address - Zip Code:12148-1350
Practice Address - Country:US
Practice Address - Phone:518-429-8717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY632385-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse