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General NPI Number Information
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NPI Number | 1659058790
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Entity Type | Individual
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Provider Name | NICOLE SILVESTRE
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Gender | Female
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 266 MIDDLE COUNTRY RD
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City | CORAM
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State | NY
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Zip | 11727-4425
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Country | US
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Telephone | 631-698-1111
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Fax | 631-698-1195
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Provider Business Mailing Address
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Address Line | 1 E ROE BLVD
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City | PATCHOGUE
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State | NY
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Zip | 11772-2631
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Country | US
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Telephone | 631-625-7210
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 351907
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License Number State | NY
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