Provider Demographics
NPI:1750047759
Name:PAVLEYEVA, OLGA (RN)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:PAVLEYEVA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 BEACH ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-2501
Mailing Address - Country:US
Mailing Address - Phone:617-412-7071
Mailing Address - Fax:
Practice Address - Street 1:6 BIGELOW ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-2384
Practice Address - Country:US
Practice Address - Phone:617-412-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-14
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2302063163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health