Provider Demographics
NPI:1174856165
Name:EZEH, SYLVIA
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:EZEH
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 1:3232 N CHESTNUT DR
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-6512
Mailing Address - Country:US
Mailing Address - Phone:718-801-7542
Mailing Address - Fax:
Practice Address - Street 1:3232 N CHESTNUT DR
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-6512
Practice Address - Country:US
Practice Address - Phone:718-801-7542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2012-11-02
Deactivation Date:2011-03-24
Deactivation Code:
Reactivation Date:2012-11-02
Provider Licenses
StateLicense IDTaxonomies
NY619912163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse