MEDICARE: ALEX CHASULWA SINKAMBA

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
1	163WC2100X	Continence Care Registered Nurse	9964686	PA
2	164W00000X	Licensed Practical Nurse	9964686	PA

General Provider Information

NPI Number	:	1699955799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX CHASULWA SINKAMBA

Provider Business Mailing Address
First Line	:	400 PARK AVE APT 28
Second Line	:
City	:	WEST MIFFLIN
State	:	PA
Zip	:	15122-2885
Country	:	US
Telephone Number	:	412-466-3101
Fax Number	:	412-466-3101

Provider Business Practice Location Address
First Line	:	400 PARK AVE APT 28
Second Line	:
City	:	WEST MIFFLIN
State	:	PA
Zip	:	15122-2885
Country	:	US
Telephone Number	:	412-466-3101
Fax Number	:	412-466-3101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2007
Last Update Date	:	11/07/2007

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