MEDICARE: SYLVAN STREET MEDICAL, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	207R00000X	Internal Medicine Physician
3	174400000X	Specialist

General Provider Information

NPI Number	:	1225689532
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYLVAN STREET MEDICAL, P.C.

Provider Business Mailing Address
First Line	:	450 LEXINGTON AVE FL 4
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-9998
Country	:	US
Telephone Number	:	888-885-2336
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 LEXINGTON AVE FL 4
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-3912
Country	:	US
Telephone Number	:	888-885-2336
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PAUL DELGIUDICE
Credential	:	MD
Telephone Number	:	603-533-1873

Provider Enumeration Date	:	09/27/2019
Last Update Date	:	06/14/2021

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Directions to “SYLVAN STREET MEDICAL, P.C. ” Practice Location

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