Provider Demographics
NPI:1588039796
Name:SYLVESTER, ROBYN (RD LPN CDN)
Entity Type:Individual
Prefix:MS
First Name:ROBYN
Middle Name:
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:RD LPN CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 RUHAMAH AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13205-3211
Mailing Address - Country:US
Mailing Address - Phone:315-339-6800
Mailing Address - Fax:315-339-8075
Practice Address - Street 1:200 W DOMINICK ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-5846
Practice Address - Country:US
Practice Address - Phone:315-339-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000368133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist