MEDICARE: SHARLENE SY M.D.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	300650	NY
2	208000000X	Pediatrics Physician	64602	AZ
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1649620626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARLENE SY M.D.

Provider Business Mailing Address
First Line	:	3411 WAYNE AVE FL 7
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2552
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3411 WAYNE AVE FL 7
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2552
Country	:	US
Telephone Number	:	623-698-5953
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2016
Last Update Date	:	02/04/2026

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