Healthcare Provider Details

I. General information

NPI: 1255430674
Provider Name (Legal Business Name): SILVA A. KARAPETIAN C.T.R.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JOHN D. DINGELL VA MEDICAL CENTER, 4646 JOHN R. ST 553/11G-PM
DETROIT MI
48201
US

IV. Provider business mailing address

3031 N. CONNECTICUT AVE
ROYAL OAK MI
48073
US

V. Phone/Fax

Practice location:
  • Phone: 313-576-4760
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number47674
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: