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General NPI Number Information
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NPI Number | 1609491042
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Entity Type | Individual
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Provider Name | DEANDRA SYLVAIN
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Gender | Female
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Dates
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Enumeration Date | 06/11/2020
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 3453 WHITE PLAINS RD
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City | BRONX
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State | NY
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Zip | 10467-5751
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Country | US
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Telephone | 347-530-2975
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Fax |
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Provider Business Mailing Address
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Address Line | 25966 CRAFT AVE
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City | ROSEDALE
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State | NY
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Zip | 11422-3031
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 350985
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 668281
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License Number State | NY
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