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General NPI Number Information
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NPI Number | 1871173260
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Entity Type | Individual
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Provider Name | RINCA SHAY SARFF RE
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Gender | Female
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Dates
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Enumeration Date | 04/10/2021
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Last Update Date | 04/10/2021
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Provider Practice Location Address
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Address Line | 4020 S 71ST ST
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City | MILWAUKEE
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State | WI
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Zip | 53220-2304
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Country | US
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Telephone | 414-312-3410
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Fax |
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Provider Business Mailing Address
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Address Line | 200 W SILVER SPRING DR STE 295
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City | GLENDALE
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State | WI
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Zip | 53217-5058
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Country | US
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Telephone | 414-312-3410
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number | 918-84
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License Number State | WI
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