Healthcare Provider Details

I. General information

NPI: 1134126162
Provider Name (Legal Business Name): DONNA SILVERNAIL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 MADISON AVE STE 15370
NEW YORK NY
10016-5101
US

IV. Provider business mailing address

123 EVERETT RD
ALBANY NY
12205-1407
US

V. Phone/Fax

Practice location:
  • Phone: 844-484-7362
  • Fax:
Mailing address:
  • Phone: 518-701-2000
  • Fax: 518-701-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number008404
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: