Healthcare Provider Details

I. General information

NPI: 1740032101
Provider Name (Legal Business Name): SYLVIA LITTLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E MOSHOLU PKWY N APT A42
BRONX NY
10467-1925
US

IV. Provider business mailing address

115 E MOSHOLU PKWY N APT A42
BRONX NY
10467-1925
US

V. Phone/Fax

Practice location:
  • Phone: 646-299-8804
  • Fax:
Mailing address:
  • Phone: 646-299-8804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: