Healthcare Provider Details

I. General information

NPI: 1356250708
Provider Name (Legal Business Name): CHELSEA MONICK SILVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WAHOO AVE
GROTON CT
06349-2324
US

IV. Provider business mailing address

TROUT AVE
GROTON CT
06340
US

V. Phone/Fax

Practice location:
  • Phone: 860-694-4123
  • Fax:
Mailing address:
  • Phone: 860-694-2876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: