Active NPI
Samuel Sylvestre
- Addiction Medicine (Family Medicine) Physician
- Valley Cottage, NY
National Provider Identifier
1003695511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Family Medicine) Physician
- License
- 207QA0401X
- Practice address
- 706 Executive Blvd Ste D
Valley Cottage, NY 10989-2039 - Phone
- (845) 309-3164
- NPI assigned
- Sep 25, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 207QA0401X | NY | Primary |
Addresses
Primary practice location
706 Executive Blvd Ste D
Valley Cottage, NY 10989-2039
Mailing address
4 Emerald LN
Suffern, NY 10901-3214
Phone (845) 405-1845
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207QA0401X | NY | MD | Addiction Medicine (Family Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1003695511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 EMERALD LN",
"city": "SUFFERN",
"state": "NY",
"postal_code": "109013214",
"telephone_number": "845-405-1845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "706 EXECUTIVE BLVD STE D",
"city": "VALLEY COTTAGE",
"state": "NY",
"postal_code": "109892039",
"telephone_number": "845-309-3164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYLVESTRE",
"first_name": "SAMUEL",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-25",
"last_updated": "2023-09-25",
"certification_date": "2023-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": "NY",
"license": "207QA0401X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley Cottage, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.