Healthcare Provider Details

I. General information

NPI: 1194613075
Provider Name (Legal Business Name): JEMIMA SILAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FAMILY PRACTICE DR
KINGSTON NY
12401-6449
US

IV. Provider business mailing address

45 BIRCH ST APT 8E
KINGSTON NY
12401-1058
US

V. Phone/Fax

Practice location:
  • Phone: 845-338-6400
  • Fax:
Mailing address:
  • Phone: 329-210-6771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: