Provider Demographics
NPI:1922320506
Name:SYTNER, MIRIAM (NP)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:SYTNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 GEDNEY WAY
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2519
Mailing Address - Country:US
Mailing Address - Phone:914-473-8580
Mailing Address - Fax:
Practice Address - Street 1:34 GEDNEY WAY
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2519
Practice Address - Country:US
Practice Address - Phone:914-473-8580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336198-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine