Healthcare Provider Details

I. General information

NPI: 1861525867
Provider Name (Legal Business Name): JILL M SILVER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 BROAD ST
PLATTSBURGH NY
12901-2637
US

IV. Provider business mailing address

40 TRAFALGAR DR
PLATTSBURGH NY
12901-1341
US

V. Phone/Fax

Practice location:
  • Phone: 518-564-2187
  • Fax: 518-564-2188
Mailing address:
  • Phone: 518-566-7130
  • Fax: 518-564-2188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF334211
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: