Healthcare Provider Details

I. General information

NPI: 1568294700
Provider Name (Legal Business Name): SYLAS PARKER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 ALBANY ST
BOSTON MA
02118-2503
US

IV. Provider business mailing address

363 ALBANY ST
BOSTON MA
02118-2503
US

V. Phone/Fax

Practice location:
  • Phone: 617-892-9100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW2143813
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: