Individual
JACK P SYLVIA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MED
Contact information
Practice address
178 PINE STREET, FALL RIVER, MA 02720
(508) 678-0091
(508) 324-9002
Mailing address
67 BRYANT ST, BERKLEY, MA 02779-1504
(508) 821-9340
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3028159
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3028159
LICENSE
MA
Enumeration date
03/24/2006
Last updated
07/08/2007
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