Healthcare Provider Details

I. General information

NPI: 1982938544
Provider Name (Legal Business Name): DR. NELSON R SILVA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2009
Last Update Date: 09/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 LAFAYETTE ST APT 350
NEW YORK NY
10003-6956
US

IV. Provider business mailing address

10 WATERSIDE PLZ APT 15A
NEW YORK NY
10010-2690
US

V. Phone/Fax

Practice location:
  • Phone: 212-443-1300
  • Fax:
Mailing address:
  • Phone: 646-250-9790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number000008-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number000008-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: