Provider Demographics
NPI:1285296806
Name:SYLLA, ROKYATOU
Entity type:Individual
Prefix:
First Name:ROKYATOU
Middle Name:
Last Name:SYLLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3019 S 68TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-3321
Mailing Address - Country:US
Mailing Address - Phone:215-880-5076
Mailing Address - Fax:
Practice Address - Street 1:3019 S 68TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-3321
Practice Address - Country:US
Practice Address - Phone:215-888-5076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator