Provider Demographics
NPI:1376570218
Name:SINCLAIR, GEORGETTE (AUD)
Entity Type:Individual
Prefix:DR
First Name:GEORGETTE
Middle Name:
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 406153
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-1876
Mailing Address - Country:US
Mailing Address - Phone:212-867-6337
Mailing Address - Fax:212-867-6506
Practice Address - Street 1:420 LEXINGTON AVE
Practice Address - Street 2:STE 315
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10170-0002
Practice Address - Country:US
Practice Address - Phone:212-867-6337
Practice Address - Fax:212-867-6506
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001367-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYM70811Medicare ID - Type Unspecified