Provider Demographics
NPI:1710241153
Name:STATON, SYLVIA ERLEEN
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:ERLEEN
Last Name:STATON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 GIVAN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-2707
Mailing Address - Country:US
Mailing Address - Phone:917-559-4449
Mailing Address - Fax:718-881-9177
Practice Address - Street 1:1616 GIVAN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-2707
Practice Address - Country:US
Practice Address - Phone:917-559-4449
Practice Address - Fax:718-881-9177
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY17613OtherDEPARTMENT OF HEALTH