Lack, Sylvia

Lack, Sylvia is an individual health care provider with primary practice located at Gaylord Farms Rd. , Wallingford CT 06492. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Lack, Sylvia can be contacted via phone (203) 284-2800.

Contact Information

Primary practice address
Gaylord Farms Rd. Wallingford CT 06492
Phone: (203) 284-2800
Fax: (203) 679-3598
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 018377 Connecticut

Profile Details

NPI number 1568443281
LBN Legal business name Lack, Sylvia
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2005
Last updated Jan 19th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568443281 NPPES
Connecticut MEDICAID 1183771

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