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General NPI Number Information
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NPI Number | 1013204064
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Entity Type | Individual
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Provider Name | RIMMA CHERNYAKHOVSKAYA SILVA D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2011
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Last Update Date | 08/06/2012
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Provider Practice Location Address
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Address Line | 216 STUYVESANT AVE
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City | LYNDHURST
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State | NJ
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Zip | 07071-1721
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Country | US
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Telephone | 201-939-8420
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Fax |
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Provider Business Mailing Address
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Address Line | 24-06 ELLINGTON RD
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City | FAIR LAWN
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State | NJ
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Zip | 07410-2944
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Country | US
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Telephone | 201-446-0232
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02504800
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License Number State | NJ
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