Healthcare Provider Details

I. General information

NPI: 1295162527
Provider Name (Legal Business Name): SYLVIA BERRIOS-SPENCER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 10/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 BURLING LN
NEW ROCHELLE NY
10801-5611
US

IV. Provider business mailing address

42 FERN ST
NEW ROCHELLE NY
10801-1607
US

V. Phone/Fax

Practice location:
  • Phone: 914-636-3237
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number070248-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: