Individual provider Active NPI

John Sylak, ATC

  • Athletic Trainer
  • Albany, NY
National Provider Identifier
1174012843
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
002085-1 Issued in NY
Practice address
1400 Washington Ave Sefcu Arena a-25
Albany, NY 12222-0001
Phone
(518) 442-3725
Fax
(518) 437-4450
NPI assigned
May 8, 2018
Last updated
May 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 002085-1 NY Primary

Addresses

Primary practice location

1400 Washington Ave Sefcu Arena a-25
Albany, NY 12222-0001

Mailing address

1400 Washington Ave Sefcu Arena a-25
Albany, NY 12222-0001

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

LicenseStateTypeSpecialty
002085-1NYMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1174012843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WASHINGTON AVE SEFCU ARENA A-25",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122220001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WASHINGTON AVE SEFCU ARENA A-25",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122220001",
            "telephone_number": "518-442-3725",
            "fax_number": "518-437-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYLAK",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "002085-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.