Healthcare Provider Details

I. General information

NPI: 1215057252
Provider Name (Legal Business Name): SYLVESTER WOJTKOWSKI PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2007
Last Update Date: 08/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 E 51ST ST SUITE C
NEW YORK NY
10022-8014
US

IV. Provider business mailing address

420 E 51ST ST SUITE C
NEW YORK NY
10022-8014
US

V. Phone/Fax

Practice location:
  • Phone: 212-754-6451
  • Fax:
Mailing address:
  • Phone: 212-754-6451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number011736
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: