Provider Demographics
NPI:1336791870
Name:ASSELSTINE, SYDNEY (MD)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:ASSELSTINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:
Other - Last Name:ASSELSTINE-SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1825 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-2106
Mailing Address - Country:US
Mailing Address - Phone:201-942-4545
Mailing Address - Fax:
Practice Address - Street 1:1825 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-2106
Practice Address - Country:US
Practice Address - Phone:201-942-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-15
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11524800207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine