Provider Demographics
NPI:1831158450
Name:SYLVIES, ROBERT B (PSYD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:B
Last Name:SYLVIES
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13396 DRAY LN
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-9596
Mailing Address - Country:US
Mailing Address - Phone:330-386-7870
Mailing Address - Fax:330-382-9075
Practice Address - Street 1:416 JACKSON ST
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-2955
Practice Address - Country:US
Practice Address - Phone:330-386-7870
Practice Address - Fax:330-382-9075
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4795103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0164339000Medicaid
OH0976592Medicaid
OHSYCP14902Medicare ID - Type Unspecified
OHR71896Medicare UPIN