Provider Demographics
NPI:1043343460
Name:SANCHEZ, ELISAMUEL (RN)
Entity type:Individual
Prefix:MR
First Name:ELISAMUEL
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 ATLANTIC AVE.
Mailing Address - Street 2:#17A
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02210-2253
Mailing Address - Country:US
Mailing Address - Phone:617-887-4670
Mailing Address - Fax:617-887-4646
Practice Address - Street 1:100 EVERETT AVE
Practice Address - Street 2:SUITE 16C
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2309
Practice Address - Country:US
Practice Address - Phone:617-887-4670
Practice Address - Fax:617-887-4646
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA194213163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator