Provider Demographics
NPI:1427242221
Name:OBER-RESSIJAC, CYNTHIA LOUISE (NNP)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LOUISE
Last Name:OBER-RESSIJAC
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 WASHINGTON ST
Mailing Address - Street 2:DIVISION OF NEWBORN MEDICINE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1526
Mailing Address - Country:US
Mailing Address - Phone:617-636-5008
Mailing Address - Fax:617-636-1456
Practice Address - Street 1:750 WASHINGTON ST
Practice Address - Street 2:DIVISION OF NEWBORN MEDICINE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1526
Practice Address - Country:US
Practice Address - Phone:617-636-5008
Practice Address - Fax:617-636-1456
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA156157363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care