Healthcare Provider Details

I. General information

NPI: 1770654121
Provider Name (Legal Business Name): JOLANTA SYKORA-SYGNAROWICZ D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S OYSTER BAY RD
SYOSSET NY
11791-6221
US

IV. Provider business mailing address

311 S OYSTER BAY RD
SYOSSET NY
11791-6221
US

V. Phone/Fax

Practice location:
  • Phone: 516-496-0627
  • Fax:
Mailing address:
  • Phone: 516-496-0627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number043085
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: