Provider Demographics
NPI:1376148932
Name:SMALL, SYLVIA E
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:E
Last Name:SMALL
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 1:568 GEORGETOWN AVE
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-3856
Mailing Address - Country:US
Mailing Address - Phone:440-725-9899
Mailing Address - Fax:
Practice Address - Street 1:568 GEORGETOWN AVE
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-3856
Practice Address - Country:US
Practice Address - Phone:440-725-9899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker