Provider Demographics
NPI:1821630906
Name:SYLVESTRE AUGUSTE, ROSELINE
Entity Type:Individual
Prefix:MRS
First Name:ROSELINE
Middle Name:
Last Name:SYLVESTRE AUGUSTE
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 1:245 WILEY ST
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-8003
Mailing Address - Country:US
Mailing Address - Phone:631-782-5121
Mailing Address - Fax:
Practice Address - Street 1:245 WILEY ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-8003
Practice Address - Country:US
Practice Address - Phone:631-782-5121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2019-12-05
Deactivation Date:2019-11-27
Deactivation Code:
Reactivation Date:2019-12-05
Provider Licenses
StateLicense IDTaxonomies
NY374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide