Provider Demographics
NPI:1730201237
Name:MISKAVITCH, SYLVIE CECILE (RN)
Entity type:Individual
Prefix:
First Name:SYLVIE
Middle Name:CECILE
Last Name:MISKAVITCH
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 1:35 GEORDIE LN
Mailing Address - Street 2:
Mailing Address - City:HUBBARDSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01452-1664
Mailing Address - Country:US
Mailing Address - Phone:978-928-4748
Mailing Address - Fax:
Practice Address - Street 1:35 GEORDIE LN
Practice Address - Street 2:
Practice Address - City:HUBBARDSTON
Practice Address - State:MA
Practice Address - Zip Code:01452-1664
Practice Address - Country:US
Practice Address - Phone:978-928-4748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210224163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0710199OtherMASS.HEALTH PROVIDER #