Healthcare Provider Details

I. General information

NPI: 1588180541
Provider Name (Legal Business Name): NATELLA ZASLAVSKY RN, BSN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2017
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 CHELSEA STREET
EVERETT MA
02149
US

IV. Provider business mailing address

18330 W PASEO WAY
GOODYEAR AZ
85338-5276
US

V. Phone/Fax

Practice location:
  • Phone: 781-388-6200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN2307212
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number240591
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: