Healthcare Provider Details

I. General information

NPI: 1316850696
Provider Name (Legal Business Name): SYLVA BAZZI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7542 WYOMING ST
DEARBORN MI
48126-1690
US

IV. Provider business mailing address

7542 WYOMING ST
DEARBORN MI
48126-1690
US

V. Phone/Fax

Practice location:
  • Phone: 313-415-1515
  • Fax:
Mailing address:
  • Phone: 313-415-1515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26216050501
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: