Provider Demographics
NPI:1619006178
Name:ALONSO, SYLVIA (OD)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:ALONSO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 PARK PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4384
Mailing Address - Country:US
Mailing Address - Phone:646-248-4144
Mailing Address - Fax:
Practice Address - Street 1:229 E 79TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0866
Practice Address - Country:US
Practice Address - Phone:212-861-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV 006907152W00000X
FLOPC 3996152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist