Healthcare Provider Details

I. General information

NPI: 1720375041
Provider Name (Legal Business Name): GABRIELLE ILYSE SYKOFF D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 02/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SUMMER STREET, 2ND FLOOR
STAMFORD CT
06905-5132
US

IV. Provider business mailing address

25 BANK ST APT 216J
WHITE PLAINS NY
10606-7007
US

V. Phone/Fax

Practice location:
  • Phone: 203-324-6171
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number055061
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number010741
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: