Provider Demographics
NPI:1639750219
Name:CIAVARINI, SEBASTIAN
Entity Type:Individual
Prefix:
First Name:SEBASTIAN
Middle Name:
Last Name:CIAVARINI
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 1:60 MAUREEN CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MAPLEVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02839
Mailing Address - Country:US
Mailing Address - Phone:401-486-6601
Mailing Address - Fax:
Practice Address - Street 1:60 MAUREEN CIRCLE
Practice Address - Street 2:
Practice Address - City:MAPLEVILLE
Practice Address - State:RI
Practice Address - Zip Code:02839
Practice Address - Country:US
Practice Address - Phone:401-486-6601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4627224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant