Provider Demographics
NPI:1386438083
Name:MAMACLAY, SYLAH REAH ALCANTARA
Entity type:Individual
Prefix:
First Name:SYLAH REAH
Middle Name:ALCANTARA
Last Name:MAMACLAY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6258 ANGORA PEAK LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-1662
Mailing Address - Country:US
Mailing Address - Phone:702-234-4125
Mailing Address - Fax:
Practice Address - Street 1:3161 E WARM SPRINGS RD STE 400
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3144
Practice Address - Country:US
Practice Address - Phone:702-463-1011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV863345163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health