MEDICARE: MISS JULIET ANNE SILVERA LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	273663-1	NY

General Provider Information

NPI Number	:	1811259021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JULIET ANNE SILVERA LPN

Provider Business Mailing Address
First Line	:	1049 E 221ST ST
Second Line	:	PH
City	:	BRONX
State	:	NY
Zip	:	10469-1231
Country	:	US
Telephone Number	:	718-924-8655
Fax Number	:

Provider Business Practice Location Address
First Line	:	1049 E 221ST ST
Second Line	:	PH
City	:	BRONX
State	:	NY
Zip	:	10469-1231
Country	:	US
Telephone Number	:	718-924-8655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2012
Last Update Date	:	06/13/2012

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