Provider Demographics
NPI:1164652129
Name:OBAYUWANA, SYLVIA
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:OBAYUWANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 UNIVERSITY AVE
Mailing Address - Street 2:3J
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-4260
Mailing Address - Country:US
Mailing Address - Phone:917-415-7647
Mailing Address - Fax:
Practice Address - Street 1:1001 UNIVERSITY AVE
Practice Address - Street 2:3J
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-4260
Practice Address - Country:US
Practice Address - Phone:917-415-7647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY582245163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse