Siri Mamounge Fobanjong

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN2261316 Issued in MA

Practice address

235 Wellesley St
Weston, MA 02493-1571

Phone

(508) 685-3516

NPI assigned

Jul 18, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1245919067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 EDDY DR",
            "city": "WESTPORT",
            "state": "MA",
            "postal_code": "027901931",
            "telephone_number": "508-685-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 WELLESLEY ST",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024931571",
            "telephone_number": "508-685-3516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOBANJONG",
        "first_name": "SIRI",
        "middle_name": "MAMOUNGE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2261316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryam Fattahy, OD
• Dahlia Phyllis Filban
• Maureen Filippine, MD
• Conor Finnegan
• Richard Paul Floyd, MD
• Jodi Foote
• Julia Forbes, RN
• Michelle Forbush
• Mary Patrice Forster, NP
• Latosha N Foster, RN

• Registered Nurse in Weston, MA
• Providers in Weston, MA by specialty
• Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.