Healthcare Provider Details

I. General information

NPI: 1528376357
Provider Name (Legal Business Name): MEREDITH SYKES M.S.ED., PD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 09/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 SCHENCK AVE APT 1A
GREAT NECK NY
11021-3626
US

IV. Provider business mailing address

90 SCHENCK AVE APT 1A
GREAT NECK NY
11021-3626
US

V. Phone/Fax

Practice location:
  • Phone: 917-447-8117
  • Fax:
Mailing address:
  • Phone: 917-447-8117
  • 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: