Provider Demographics
NPI:1669841581
Name:SYLVIA NAMBASSA
Entity Type:Organization
Organization Name:SYLVIA NAMBASSA
Other - Org Name:SYLVIA NAMBASSA
Other - Org Type:Other Name
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAMBASSA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:774-270-1406
Mailing Address - Street 1:13 WINN PARK
Mailing Address - Street 2:#13 B
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-3020
Mailing Address - Country:US
Mailing Address - Phone:774-270-1406
Mailing Address - Fax:
Practice Address - Street 1:13 WINN PARK
Practice Address - Street 2:#13B
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-3020
Practice Address - Country:US
Practice Address - Phone:774-270-1406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2289616251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care