Healthcare Provider Details

I. General information

NPI: 1326552548
Provider Name (Legal Business Name): SYLVAN HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2017
Last Update Date: 11/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 57TH ST STE 801
BROOKLYN NY
11220-3797
US

IV. Provider business mailing address

19 MICHAEL ROBERTS CT
PEARL RIVER NY
10965-3332
US

V. Phone/Fax

Practice location:
  • Phone: 718-576-6881
  • Fax: 718-228-8689
Mailing address:
  • Phone: 845-201-8457
  • Fax: 201-632-7000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number07484
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number5665
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. YOU GUANG DING
Title or Position: PHYSICIAN
Credential: MD
Phone: 201-888-4838