Basic Information
Provider Information
NPI: 1740411362
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SYLVESTRE
FirstName: VONETTA
MiddleName: TAMARA
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6200 BEACH CHANNEL DR
Address2:  
City: ARVERNE
State: NY
PostalCode: 116921409
CountryCode: US
TelephoneNumber: 7189457150
FaxNumber: 7189452596
Practice Location
Address1: 6200 BEACH CHANNEL DR
Address2:  
City: ARVERNE
State: NY
PostalCode: 116921409
CountryCode: US
TelephoneNumber: 7189457150
FaxNumber: 7189452596
Other Information
ProviderEnumerationDate: 07/30/2009
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X254188NYY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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