Healthcare Provider Details

I. General information

NPI: 1316859481
Provider Name (Legal Business Name): NISALI R SILVA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 SCHENECTADY AVE FL 3
BROOKLYN NY
11213-2330
US

IV. Provider business mailing address

300 LAKE AVE
STATEN ISLAND NY
10303-2610
US

V. Phone/Fax

Practice location:
  • Phone: 347-915-1112
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number130710
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: