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General NPI Number Information
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NPI Number | 1467520239
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Entity Type | Individual
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Provider Name | SILVANA GAUDINO MD
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Gender | Female
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 127 PINE ST STE 10
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City | MONTCLAIR
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State | NJ
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Zip | 07042-4869
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Country | US
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Telephone | 973-707-2122
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Fax | 973-655-9559
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Provider Business Mailing Address
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Address Line | 33 NORTH FULLERTON AVENUE
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3412
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Country | US
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Telephone | 973-744-2226
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Fax | 973-509-0978
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 25MA04978100
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License Number State | NJ
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