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NPI Code Detail

MEDICARE: BRENDA CHARLENE ZYLSTRA NP

MEDICARE: BRENDA CHARLENE ZYLSTRA NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician193835MA

General Provider Information

NPI Number : 1013081421
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA CHARLENE ZYLSTRA NP
Provider Business Mailing Address
First Line : 9 INDUSTRIAL RD 5
Second Line :
City : MILFORD
State : MA
Zip : 01757-3736
Country : US
Telephone Number : 508-473-1480
Fax Number : 508-473-1210
Provider Business Practice Location Address
First Line : 100 COMMERCE DR
Second Line :
City : NORTHBRIDGE
State : MA
Zip : 01534-1415
Country : US
Telephone Number : 508-234-6260
Fax Number : 508-234-0764
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2006
Last Update Date : 12/07/2015

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