Provider Demographics
NPI:1174833859
Name:RALPH, SYLVIA G (LPN)
Entity type:Individual
Prefix:MISS
First Name:SYLVIA
Middle Name:G
Last Name:RALPH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-3052
Mailing Address - Country:US
Mailing Address - Phone:631-473-1200
Mailing Address - Fax:
Practice Address - Street 1:22 W MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-3052
Practice Address - Country:US
Practice Address - Phone:631-473-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246380-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse