Provider Demographics
NPI:1205340536
Name:SANON, SYLVIA PRISCYLLA
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:PRISCYLLA
Last Name:SANON
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 1:600 KINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-1704
Mailing Address - Country:US
Mailing Address - Phone:718-221-1097
Mailing Address - Fax:
Practice Address - Street 1:600 KINGSTON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1704
Practice Address - Country:US
Practice Address - Phone:718-221-1097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-22
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028589235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist