Healthcare Provider Details

I. General information

NPI: 1164349833
Provider Name (Legal Business Name): SAYRA M PEREZ NIEVES CHW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CENTRAL ST
PROVIDENCE RI
02907-2201
US

IV. Provider business mailing address

7 CENTRAL ST
PROVIDENCE RI
02907-2201
US

V. Phone/Fax

Practice location:
  • Phone: 401-648-4700
  • Fax: 833-905-2260
Mailing address:
  • Phone: 401-648-4700
  • Fax: 833-905-2260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number202012
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: