Healthcare Provider Details

I. General information

NPI: 1326181843
Provider Name (Legal Business Name): MAURICIO JOSE SILVA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3758 91ST ST # 2
JACKSON HEIGHTS NY
11372-7928
US

IV. Provider business mailing address

3758 91ST ST # 2
JACKSON HEIGHTS NY
11372-7928
US

V. Phone/Fax

Practice location:
  • Phone: 929-232-1868
  • Fax: 929-205-7901
Mailing address:
  • Phone: 929-232-1868
  • Fax: 929-205-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number242508-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number242508-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: