Provider Demographics
NPI:1568492668
Name:COLON CABASSA, SYLVIA (RN,APNC,FNP)
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:
Last Name:COLON CABASSA
Suffix:
Gender:F
Credentials:RN,APNC,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1411
Mailing Address - Country:US
Mailing Address - Phone:201-501-0564
Mailing Address - Fax:201-501-0564
Practice Address - Street 1:441 E FORDHAM RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5149
Practice Address - Country:US
Practice Address - Phone:718-817-4164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33-333204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily