Healthcare Provider Details

I. General information

NPI: 1609668979
Provider Name (Legal Business Name): SYLVIE C LIFTIN BS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SILVER C LIFTIN BS

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

369 LEXINGTON AVE RM 14A
NEW YORK NY
10017-6526
US

IV. Provider business mailing address

68 JAY ST STE 501
BROOKLYN NY
11201-8375
US

V. Phone/Fax

Practice location:
  • Phone: 212-204-8430
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number42614
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: