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General NPI Number Information
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NPI Number | 1366126468
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Entity Type | Individual
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Provider Name | SILVIA FANNY LARA-MOSES MD, PA
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Gender | Female
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Dates
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Enumeration Date | 06/09/2023
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 925 N 87TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53226-4812
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Country | US
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Telephone | 414-955-2020
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Fax | 414-955-6300
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Provider Business Mailing Address
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Address Line | 925 N 87TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53226-4812
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Country | US
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Telephone | 414-955-2020
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Fax | 414-955-6300
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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 | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) Physician
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License Number | 85462-875
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 001620-P.A.
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) Physician
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License Number | 3279381
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License Number State | ZZ
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 001620-P.A.
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License Number State | PR
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Taxonomy #5
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 001620-P.A.
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License Number State | PR
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