Healthcare Provider Details

I. General information

NPI: 1679970578
Provider Name (Legal Business Name): STEPHEN WAYNE SYKEN VMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2014
Last Update Date: 11/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 MARIANVILLE RD
ASTON PA
19014-2754
US

IV. Provider business mailing address

413 MARIANVILLE RD
ASTON PA
19014-2754
US

V. Phone/Fax

Practice location:
  • Phone: 610-497-4000
  • Fax: 610-497-8853
Mailing address:
  • Phone: 610-497-4000
  • Fax: 610-497-8853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License NumberBV-006055L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: