Healthcare Provider Details

I. General information

NPI: 1295338432
Provider Name (Legal Business Name): SYDNE FAY PUK-SILVERSTEIN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 11/19/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7701 13TH AVE
BROOKLYN NY
11228-2413
US

IV. Provider business mailing address

7701 13TH AVE
BROOKLYN NY
11228-2413
US

V. Phone/Fax

Practice location:
  • Phone: 718-232-1351
  • Fax:
Mailing address:
  • Phone: 718-232-1351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number110627
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: