NICOLE SIDDON PA-C
NPI 1497204275
Physician Assistant - Medical in Syracuse, NY

The NPI number for Nicole Siddon is 1497204275. It was assigned to this individual provider in the NPPES registry on September 22, 2016.

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

The NPPES record for Nicole Siddon was last updated on April 11, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 22, 2016

NPPES record last updated: April 11, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 11, 2024, Sep 22, 2016 (2 updates tracked since 2016).

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About Nicole Siddon Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE SIDDON PA-C (NPI 1497204275) is an individual medical provider in Syracuse, New York and active in the NPI registry since September 2016.

NPI1497204275

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameNICOLE SIDDONCredential: PA-C

Location Address736 IRVING AVE, #9100Syracuse, NY 13210-1687

Mailing Address5844 Sutton DrCicero, NY 13039-9582 · (201) 953-3320

Sole ProprietorNo

Enumeration DateSeptember 22, 2016

Last NPPES UpdateApril 11, 20242 updates tracked since enumeration

NPPES CertifiedApril 11, 2024

✔ NPI 1497204275 is a valid, active identifier and passes the ISO check-digit test.

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

736 IRVING AVE, Syracuse, NY 13210

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine