Healthcare Provider Details

I. General information

NPI: 1780308635
Provider Name (Legal Business Name): SILVANO DIMONTE JR. PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 RIDGEWOOD RD STE 400
WYOMISSING PA
19610-1193
US

IV. Provider business mailing address

2201 RIDGEWOOD RD STE 400
WYOMISSING PA
19610-1193
US

V. Phone/Fax

Practice location:
  • Phone: 610-378-9601
  • Fax: 610-378-9061
Mailing address:
  • Phone: 610-378-9601
  • Fax: 610-378-9061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP037379
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: