Healthcare Provider Details

I. General information

NPI: 1316141617
Provider Name (Legal Business Name): HEATHER LYNN SILVA OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 KINGS HWY N FOX REHABILITATION SERVICES
CHERRY HILL NJ
08034-1513
US

IV. Provider business mailing address

12 W JUDITH DR
HAMMONTON NJ
08037-9614
US

V. Phone/Fax

Practice location:
  • Phone: 877-407-3422
  • Fax: 877-407-4329
Mailing address:
  • Phone: 877-407-3422
  • Fax: 877-407-4329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number46TR00392500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: