Provider Demographics
NPI:1750749859
Name:ALAKUSHEVA, SYLVIA (CLINICAL NUTRITIONIS)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:ALAKUSHEVA
Suffix:
Gender:F
Credentials:CLINICAL NUTRITIONIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 REGENT RD
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-7522
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35 REGENT RD
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-7522
Practice Address - Country:US
Practice Address - Phone:617-880-9225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist