Provider Demographics
NPI:1275826562
Name:SYKES, PHYLLIS ROSENBLOOM (PT)
Entity Type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:ROSENBLOOM
Last Name:SYKES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6505 TROTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2525
Mailing Address - Country:US
Mailing Address - Phone:410-458-4644
Mailing Address - Fax:
Practice Address - Street 1:6505 TROTWOOD CT
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2525
Practice Address - Country:US
Practice Address - Phone:410-458-4644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16015225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist