Provider Demographics
NPI:1538371760
Name:SINCLAIR, PATRICIA LYN
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYN
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21441 EASTWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126
Mailing Address - Country:US
Mailing Address - Phone:440-567-9691
Mailing Address - Fax:
Practice Address - Street 1:21441 EASTWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126
Practice Address - Country:US
Practice Address - Phone:440-567-9691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2640995Medicaid