Provider Demographics
NPI:1144049743
Name:ALFARO RAYMOND, SIRSY MANUELA
Entity type:Individual
Prefix:
First Name:SIRSY
Middle Name:MANUELA
Last Name:ALFARO RAYMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 SPENCER ST APT 58
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6246
Mailing Address - Country:US
Mailing Address - Phone:254-482-4026
Mailing Address - Fax:
Practice Address - Street 1:1650 E SAHARA AVE STE 4
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3495
Practice Address - Country:US
Practice Address - Phone:702-792-0111
Practice Address - Fax:702-836-0972
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant