Healthcare Provider Details

I. General information

NPI: 1073000949
Provider Name (Legal Business Name): MRS. MAGGIE SILVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. MAGGIE AWAD

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 10/25/2020
Certification Date: 10/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11606 MYRTLE AVE
RICHMOND HILL NY
11418-1748
US

IV. Provider business mailing address

16015 79TH ST
HOWARD BEACH NY
11414-2912
US

V. Phone/Fax

Practice location:
  • Phone: 917-842-8904
  • Fax:
Mailing address:
  • Phone: 718-683-8003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: