Provider Demographics
NPI:1881690980
Name:WOOD, SYLVIA K (DNP, ANP-BC)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:K
Last Name:WOOD
Suffix:
Gender:F
Credentials:DNP, ANP-BC
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 1554
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0988
Mailing Address - Country:US
Mailing Address - Phone:631-444-0650
Mailing Address - Fax:631-638-4170
Practice Address - Street 1:3 EDMUND D PELLEGRINO RD
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-1008
Practice Address - Country:US
Practice Address - Phone:631-444-3577
Practice Address - Fax:631-444-2112
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302505363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02219161Medicaid
NYP05458Medicare UPIN
NY02219161Medicaid