Provider Demographics
NPI:1538192000
Name:SYLVESTRE, TAMARA H (MSPT)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:H
Last Name:SYLVESTRE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:H
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:30 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3341
Mailing Address - Country:US
Mailing Address - Phone:401-775-1500
Mailing Address - Fax:
Practice Address - Street 1:30 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3341
Practice Address - Country:US
Practice Address - Phone:401-775-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01936225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI2058OtherSS NHPRC
RI413176OtherSS BCHIP
RI6400144OtherSS UHP
RI99947OtherSS BCROSS