Provider Demographics
NPI:1962458398
Name:SYLVERIC HEALTHCARE CENTER INC
Entity Type:Organization
Organization Name:SYLVERIC HEALTHCARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOYE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:973-249-1855
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:STANHOPE
Mailing Address - State:NJ
Mailing Address - Zip Code:07874-0428
Mailing Address - Country:US
Mailing Address - Phone:201-512-9494
Mailing Address - Fax:
Practice Address - Street 1:642 BROAD ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-1615
Practice Address - Country:US
Practice Address - Phone:973-249-1855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA63691174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7801505Medicaid
NJ7801505Medicaid
NJ022067Medicare ID - Type Unspecified