Provider Demographics
NPI:1851341861
Name:SYLVAN, GOSLYN RHEUBEN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GOSLYN
Middle Name:RHEUBEN
Last Name:SYLVAN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:500 MERRIMACK ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1756
Mailing Address - Country:US
Mailing Address - Phone:978-557-8900
Mailing Address - Fax:978-557-8856
Practice Address - Street 1:500 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1756
Practice Address - Country:US
Practice Address - Phone:978-557-8900
Practice Address - Fax:978-557-8856
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2012-11-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA227335207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1851341861OtherAETNA HMO
MA060030OtherTUFTS
MA2129213Medicaid
MA04-34240OtherEVERCARE
NH30206616OtherNH MEDICAID
MA110075219AOtherMASS HEALTH
MAJ41248OtherBLUE CROSS BLUE SHIELD
MAP00983242OtherRAILROAD MEDICARE
MA1851341861OtherFALLON COMMUNITY HEALTH PLAN
MA7057935OtherAETNA NON HMO
MA0040560OtherNEIGHBORHOOD HEALTH PLAN
MAAA79528OtherHARVARD PILGRIM HEALTHCAR
MA495605OtherTUFTS
MA959730-01OtherNETWORK HEALTH
MA0040560OtherNEIGHBORHOOD HEALTH PLAN
MA1851341861OtherFALLON COMMUNITY HEALTH PLAN