Provider Demographics
NPI:1669445912
Name:SIFONTE, MYRTA N (MD)
Entity type:Individual
Prefix:DR
First Name:MYRTA
Middle Name:N
Last Name:SIFONTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MYRTA
Other - Middle Name:N
Other - Last Name:SIFONTE RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:UNIT 33100 BOX LANDSTUHL
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180-3100
Mailing Address - Country:US
Mailing Address - Phone:314-590-6311
Mailing Address - Fax:
Practice Address - Street 1:LANDSTUHL REGIONAL MEDICAL CENTER
Practice Address - Street 2:UNIT 33100
Practice Address - City:APO AE
Practice Address - State:GERMANY
Practice Address - Zip Code:09180
Practice Address - Country:DE
Practice Address - Phone:314-590-6311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR134262084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry