Provider Demographics
NPI:1548829344
Name:SYLVESTER-CROSS, JAZMYN
Entity type:Individual
Prefix:
First Name:JAZMYN
Middle Name:
Last Name:SYLVESTER-CROSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:466 JAMES RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05455
Mailing Address - Country:US
Mailing Address - Phone:802-373-1995
Mailing Address - Fax:
Practice Address - Street 1:110 FAIRFAX RD
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-6299
Practice Address - Country:US
Practice Address - Phone:802-752-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program