Provider Demographics
NPI:1639702434
Name:BARRASSO, SILVA (RD)
Entity Type:Individual
Prefix:
First Name:SILVA
Middle Name:
Last Name:BARRASSO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 ODELL AVE
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-3679
Mailing Address - Country:US
Mailing Address - Phone:617-320-7602
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 207P
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6104
Practice Address - Country:US
Practice Address - Phone:617-320-7602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-20
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered