Provider Demographics
NPI:1285763466
Name:SIBALIS, STEPHEN J (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:J
Last Name:SIBALIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BROWNING AVENUE
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ON
Mailing Address - Zip Code:M4K1V7
Mailing Address - Country:CA
Mailing Address - Phone:416-923-8666
Mailing Address - Fax:
Practice Address - Street 1:905-208 BLOOR STREET
Practice Address - Street 2:WEST
Practice Address - City:TORONTO
Practice Address - State:ON
Practice Address - Zip Code:M5S3B4
Practice Address - Country:CA
Practice Address - Phone:416-923-8666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA486602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry