Healthcare Provider Details

I. General information

NPI: 1053147918
Provider Name (Legal Business Name): HANNAH SILVA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 HUNTINGTON AVE
BOSTON MA
02115-5000
US

IV. Provider business mailing address

55 GOODALE ST
WEST BOYLSTON MA
01583-1005
US

V. Phone/Fax

Practice location:
  • Phone: 617-373-2000
  • Fax:
Mailing address:
  • Phone: 508-425-0782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA102253
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: