Provider Demographics
NPI:1114391232
Name:TIFFANY SYLVESTRE
Entity type:Organization
Organization Name:TIFFANY SYLVESTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:SYLVESTRE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:212-442-4488
Mailing Address - Street 1:60 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4048
Mailing Address - Country:US
Mailing Address - Phone:347-512-6871
Mailing Address - Fax:
Practice Address - Street 1:2069 E 41ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2904
Practice Address - Country:US
Practice Address - Phone:347-512-6871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020109103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty