Individual ProviderDermaine B SaddlerRegistered NurseNursing Service ProvidersPractice Address3308 Wickhma Avenue, Apt. 1, Bronx, NY 10469(347) 463-3552PECOS EnrollmentBased on the most recent information from CMS, provider Dermaine B Saddler does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1255733945Provider TypeIndividualFull NameSaddler, Dermaine BGenderMaleSole ProprietorNoEnumeration Date9/24/2014Last Updated6/19/2019Contact InformationPractice LocationPractice Address3308 Wickhma Avenue, Apt. 1, Bronx, NY 10469Phone(347) 463-3552FaxUnlisted FaxMailing LocationMailing Address3308 Wickham Ave, Apt. 1, Bronx, NY 10469-2736Phone(347) 463-3552FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense755166New YorkCode164W00000XDescriptionLicensed Practical NurseNursing Service ProvidersLicense319142New York