Provider Demographics
NPI:1831801992
Name:SYLVA MEDICAL PRACTICE, PLLC
Entity type:Organization
Organization Name:SYLVA MEDICAL PRACTICE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN SYLVESTRE
Authorized Official - Middle Name:
Authorized Official - Last Name:AYISSI ESSONO
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:445-544-0210
Mailing Address - Street 1:137 VALENCIA RD
Mailing Address - Street 2:
Mailing Address - City:RENFREW
Mailing Address - State:PA
Mailing Address - Zip Code:16053-9459
Mailing Address - Country:US
Mailing Address - Phone:445-544-0210
Mailing Address - Fax:
Practice Address - Street 1:175 PROGRESS DR
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-8082
Practice Address - Country:US
Practice Address - Phone:724-852-2902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center