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General NPI Number Information
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NPI Number | 1205051604
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Entity Type | Organization
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Legal Business Name | MALIKA S. DE SILVA MD. INC
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1503 ST GEORGES AVE SUITE104
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City | COLONIA
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State | NJ
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Zip | 07067-3427
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Country | US
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Telephone | 732-388-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 1503 ST GEORGES AVE SUITE104
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City | COLONIA
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State | NJ
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Zip | 07067-3427
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Country | US
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Telephone | 732-388-5577
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Fax |
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Authorized Official
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Title or Position | ATTENDING
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Name | DR. MALIKA SHANI DE SILVA
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Credential | MD
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Telephone | 732-738-3244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | MA07781900
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License Number State | NJ
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