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General NPI Number Information
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NPI Number | 1982798914
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Entity Type | Individual
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Provider Name | JEANETTE JIMENEZ-SILVA MD
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 201 LAUREL HEIGHTS DR
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City | BRIDGETON
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State | NJ
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Zip | 08302-3635
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Country | US
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Telephone | 856-455-4800
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Fax | 856-451-0650
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Provider Business Mailing Address
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Address Line | 8 RAINBOW TER
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City | PITTSGROVE
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State | NJ
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Zip | 08318-4039
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Country | US
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Telephone | 856-455-4800
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Fax | 856-451-0650
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MA58631
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License Number State | NJ
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