Provider Demographics
NPI:1497515381
Name:BARNUM, SYDNEY PAOLE ANNE CENIZA (RPH)
Entity Type:Individual
Prefix:
First Name:SYDNEY PAOLE ANNE
Middle Name:CENIZA
Last Name:BARNUM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 S FORT APACHE RD UNIT 2193
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5721
Mailing Address - Country:US
Mailing Address - Phone:702-250-9390
Mailing Address - Fax:
Practice Address - Street 1:8633 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5406
Practice Address - Country:US
Practice Address - Phone:702-383-9660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV23599183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist