Individual provider Active NPI

Sierra Dior Petrosino, RN

  • School Registered Nurse
  • Saratoga Springs, NY
National Provider Identifier
1639903396
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
733418 Issued in NY
Practice address
15 Henning Rd Ofc
Saratoga Springs, NY 12866-3749
Phone
(518) 581-3617
Fax
(518) 581-3688
NPI assigned
Aug 27, 2024
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 733418 NY Primary

Addresses

Primary practice location

15 Henning Rd Ofc
Saratoga Springs, NY 12866-3749

Mailing address

1 Bluebird CT
Saratoga Springs, NY 12866-6153
Phone (518) 491-8951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
733418NYMDSchool Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1639903396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BLUEBIRD CT",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128666153",
            "telephone_number": "518-491-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 HENNING RD OFC",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128663749",
            "telephone_number": "518-581-3617",
            "fax_number": "518-581-3688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSINO",
        "first_name": "SIERRA",
        "middle_name": "DIOR",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "733418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.