Healthcare Provider Details

I. General information

NPI: 1619936622
Provider Name (Legal Business Name): SYLVIA M PURUGGANAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 GOLDEN HILL LN ULSTER COUNTY DEPARTMENT OF MENTAL HEALTH
KINGSTON NY
12401-6441
US

IV. Provider business mailing address

239 GOLDEN HILL LN ULSTER COUNTY DEPARTMENT OF MENTAL HEALTH
KINGSTON NY
12401-6441
US

V. Phone/Fax

Practice location:
  • Phone: 845-340-4000
  • Fax: 845-340-4070
Mailing address:
  • Phone: 845-340-4000
  • Fax: 845-340-4070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number041088
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number154247
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number041088
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: