Provider Demographics
NPI:1124146766
Name:FOGEL, SYLVIA PAULETTE (MD)
Entity type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:PAULETTE
Last Name:FOGEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SYLVIA
Other - Middle Name:PAULETTE
Other - Last Name:EMMERICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:45 OLD FARM RD
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-1423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:169 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4641
Practice Address - Country:US
Practice Address - Phone:781-923-7000
Practice Address - Fax:212-874-5459
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2197542084P0800X
CT0533712084P0800X
MA2673582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry