Provider Demographics
NPI:1871874479
Name:PETIT, SYLVIA JEANETTE (RPH)
Entity type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:JEANETTE
Last Name:PETIT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29030 NORTHWESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1010
Mailing Address - Country:US
Mailing Address - Phone:248-356-1757
Mailing Address - Fax:248-356-1857
Practice Address - Street 1:29030 NORTHWESTERN HWY
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1010
Practice Address - Country:US
Practice Address - Phone:248-356-1757
Practice Address - Fax:248-356-1857
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302029402183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist