Provider Demographics
NPI:1124369277
Name:FAMINI, RUFA MYLENE SIBAYAN
Entity Type:Individual
Prefix:
First Name:RUFA MYLENE
Middle Name:SIBAYAN
Last Name:FAMINI
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 1:215 KIMSHAM ST
Mailing Address - Street 2:
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-7124
Mailing Address - Country:US
Mailing Address - Phone:907-747-0626
Mailing Address - Fax:
Practice Address - Street 1:215 KIMSHAM ST
Practice Address - Street 2:
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-7124
Practice Address - Country:US
Practice Address - Phone:907-747-0626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNUA A 6756282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital