Provider Demographics
NPI:1427337757
Name:SYLVESTER, KATELYN JOANNA (PHARMD, BCPS)
Entity type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:JOANNA
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:JOANNA
Other - Last Name:SHANAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, BCPS
Mailing Address - Street 1:11050 MOUNT BELVEDERE BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT DRUM
Mailing Address - State:NY
Mailing Address - Zip Code:13602-5438
Mailing Address - Country:US
Mailing Address - Phone:315-774-5652
Mailing Address - Fax:315-772-1691
Practice Address - Street 1:USA MEDDAC
Practice Address - Street 2:11050 MOUNT BELVEDERE BLVD
Practice Address - City:FORT DRUM
Practice Address - State:NY
Practice Address - Zip Code:13602
Practice Address - Country:US
Practice Address - Phone:315-774-5652
Practice Address - Fax:315-772-1691
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055895183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist