Healthcare Provider Details

I. General information

NPI: 1215979323
Provider Name (Legal Business Name): ROBERT L SYLVESTER II D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 KINDERKAMACK RD SUITE 207
RIVER EDGE NJ
07661-1939
US

IV. Provider business mailing address

130 KINDERKAMACK RD SUITE 207
RIVER EDGE NJ
07661-1939
US

V. Phone/Fax

Practice location:
  • Phone: 201-488-2663
  • Fax: 201-488-0821
Mailing address:
  • Phone: 201-488-2663
  • Fax: 201-488-0821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberMC02491
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: