Provider Demographics
NPI:1710303086
Name:GUIGUI, SYDELL
Entity Type:Individual
Prefix:
First Name:SYDELL
Middle Name:
Last Name:GUIGUI
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 1:1976 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-3242
Mailing Address - Country:US
Mailing Address - Phone:917-392-4009
Mailing Address - Fax:
Practice Address - Street 1:1976 E 9TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-3242
Practice Address - Country:US
Practice Address - Phone:917-392-4009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist