Provider Demographics
NPI:1326552548
Name:SYLVAN HEALTHCARE INC
Entity type:Organization
Organization Name:SYLVAN HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:YOU GUANG
Authorized Official - Middle Name:
Authorized Official - Last Name:DING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-888-4838
Mailing Address - Street 1:19 MICHAEL ROBERTS CT
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-3332
Mailing Address - Country:US
Mailing Address - Phone:845-201-8457
Mailing Address - Fax:201-632-7000
Practice Address - Street 1:849 57TH ST STE 801
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3797
Practice Address - Country:US
Practice Address - Phone:718-576-6881
Practice Address - Fax:718-228-8689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO07484207U00000X
MD5665207UN0901X
208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Single Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02735248Medicaid