Healthcare Provider Details

I. General information

NPI: 1114094950
Provider Name (Legal Business Name): CYNTHIA KUDJI SYLVESTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ESPLANADE AVE STE 412
KENNER LA
70065-2475
US

IV. Provider business mailing address

200 W ESPLANADE AVE STE 412
KENNER LA
70065-2475
US

V. Phone/Fax

Practice location:
  • Phone: 504-464-2940
  • Fax: 504-464-2941
Mailing address:
  • Phone: 504-464-2940
  • Fax: 504-464-2941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number322854
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number347680
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN086647
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: