Healthcare Provider Details

I. General information

NPI: 1245817592
Provider Name (Legal Business Name): MICHELLE ROSARIE SYED RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 UNION ST
LYNN MA
01901-1353
US

IV. Provider business mailing address

364 PARK ST
NORTH READING MA
01864-2159
US

V. Phone/Fax

Practice location:
  • Phone: 781-581-3900
  • Fax:
Mailing address:
  • Phone: 617-538-1292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number203435
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: