Breanna Marie Syslo

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

572 Route 6 Ste 102
Mahopac, NY 10541-4787

Phone

(845) 249-8110

NPI assigned

Feb 3, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1659025104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 258",
            "city": "PLATTEKILL",
            "state": "NY",
            "postal_code": "125680258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 ROUTE 6 STE 102",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105414787",
            "telephone_number": "845-249-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYSLO",
        "first_name": "BREANNA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Lee Smith, DMD
• Stacey Smith
• Valerie Smith, RN
• John D Stevens Jr., DDS
• Dorothy Swarm, RN
• Jill Beth Talcovitz, R.N.
• Nisha Taneja, PHARMD
• Fidencio Carlos Arciaga Tani
• Laura Tarantino
• Imani Nicole Thomas, M.A CF-SLP

• Early Intervention Provider Agency in Mahopac, NY
• Providers in Mahopac, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.