Healthcare Provider Details

I. General information

NPI: 1467278424
Provider Name (Legal Business Name): SYLVIA JOSEPH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 CHERRY ST STE 2
LEESPORT PA
19533-8503
US

IV. Provider business mailing address

60 CHERRY ST STE 2
LEESPORT PA
19533-8503
US

V. Phone/Fax

Practice location:
  • Phone: 484-822-4840
  • Fax: 484-822-4842
Mailing address:
  • Phone: 484-822-4840
  • Fax: 484-822-4842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA066239
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberOA007103
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: