Healthcare Provider Details

I. General information

NPI: 1023084118
Provider Name (Legal Business Name): SALLY ANNE SVEDA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 SUNHILL LN
NEWTON CENTER MA
02459-2403
US

IV. Provider business mailing address

20 SUNHILL LN
NEWTON CENTER MA
02459-2403
US

V. Phone/Fax

Practice location:
  • Phone: 617-244-1740
  • Fax: 617-244-5592
Mailing address:
  • Phone: 617-244-1740
  • Fax: 617-244-5592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number40567
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: