Provider Demographics
NPI:1881461358
Name:MASEBE, SILIBAZISO
Entity type:Individual
Prefix:
First Name:SILIBAZISO
Middle Name:
Last Name:MASEBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 TRADECENTER STE 5900
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-7471
Mailing Address - Country:US
Mailing Address - Phone:617-468-1115
Mailing Address - Fax:
Practice Address - Street 1:400 TRADECENTER STE 5900
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-7471
Practice Address - Country:US
Practice Address - Phone:617-468-1115
Practice Address - Fax:844-440-2345
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN284761363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health