=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114800026
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SYDNIE INOSIA JEAN-NOEL
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2025
-----------------------------------------------------
Last Update Date | 07/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22806 LINDEN BLVD
-----------------------------------------------------
City | CAMBRIA HEIGHTS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11411-1846
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-712-1219
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 119 MADISON AVE
-----------------------------------------------------
City | GARDEN CITY PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11040-5228
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-263-8789
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 126581
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------