Provider Demographics
NPI:1619099439
Name:CONDY, SYLVIA ROBBINS (PHD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:ROBBINS
Last Name:CONDY
Suffix:
Gender:F
Credentials:PHD
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 230566
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99523-0566
Mailing Address - Country:US
Mailing Address - Phone:907-333-5333
Mailing Address - Fax:907-677-5967
Practice Address - Street 1:2550 DENALI ST
Practice Address - Street 2:SUITE 1505
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2736
Practice Address - Country:US
Practice Address - Phone:907-333-5333
Practice Address - Fax:907-677-5967
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAK259103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKTCHYFMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER