Healthcare Provider Details

I. General information

NPI: 1083231237
Provider Name (Legal Business Name): ALEEYAH SYDNOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2020
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 BURRS LN
DIX HILLS NY
11746-6052
US

IV. Provider business mailing address

16 SAMPSON AVE
ISLANDIA NY
11749-6142
US

V. Phone/Fax

Practice location:
  • Phone: 631-253-3480
  • Fax:
Mailing address:
  • Phone: 631-220-8122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number101032
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number101112
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: