Provider Demographics
NPI:1457361719
Name:MARZULLO, SYLVIA (PT OCS)
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:
Last Name:MARZULLO
Suffix:
Gender:F
Credentials:PT OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216
Mailing Address - Country:US
Mailing Address - Phone:716-874-2759
Mailing Address - Fax:716-874-2913
Practice Address - Street 1:2625 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14216
Practice Address - Country:US
Practice Address - Phone:716-874-2759
Practice Address - Fax:716-874-2913
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00618822251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000628235OtherBLUE CROSS
NY9353652OtherINDEPEN HEALTH ASSOC
NY00011173701OtherUNIVERA
NYBB8802Medicare ID - Type Unspecified