Provider Demographics
NPI:1275601734
Name:SYLVESTER, KATI S (PA-C)
Entity Type:Individual
Prefix:
First Name:KATI
Middle Name:S
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:S
Other - Last Name:SYLVESTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:472 WHITNEY AVE APT C1
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2321
Mailing Address - Country:US
Mailing Address - Phone:203-623-4408
Mailing Address - Fax:
Practice Address - Street 1:20 YORK STREET
Practice Address - Street 2:2ND FLOOR SOUTH PAVILION
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510
Practice Address - Country:US
Practice Address - Phone:203-747-5653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001865363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant