Provider Demographics
NPI:1366841520
Name:NGENE, SYLVESTER
Entity Type:Individual
Prefix:
First Name:SYLVESTER
Middle Name:
Last Name:NGENE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 41ST ST NW
Mailing Address - Street 2:STE A 19
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-1304
Mailing Address - Country:US
Mailing Address - Phone:507-202-2423
Mailing Address - Fax:507-216-8165
Practice Address - Street 1:1701 41ST ST NW
Practice Address - Street 2:STE A 19
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-1304
Practice Address - Country:US
Practice Address - Phone:507-202-2423
Practice Address - Fax:507-216-8165
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR189159-3163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health