Provider Demographics
NPI:1447672654
Name:SYLVESTER, SHARNEQUE ANASTACIA (LPN)
Entity type:Individual
Prefix:
First Name:SHARNEQUE
Middle Name:ANASTACIA
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ANASTACIA
Other - Middle Name:SHARNEQUE
Other - Last Name:SYLVESTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2722 CONCORD DR
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3508
Mailing Address - Country:US
Mailing Address - Phone:718-930-3943
Mailing Address - Fax:
Practice Address - Street 1:2052 TILLOTSON AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-1560
Practice Address - Country:US
Practice Address - Phone:718-671-2100
Practice Address - Fax:347-964-0790
Is Sole Proprietor?:No
Enumeration Date:2014-01-08
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317152164W00000X
NY763044163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No164W00000XNursing Service ProvidersLicensed Practical Nurse