MEDICARE: MAURICIO JOSE SILVA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	242508-1	NY
2	207V00000X	Obstetrics & Gynecology Physician	242508-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326181843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAURICIO JOSE SILVA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 528
Second Line	:
City	:	CORNWALL
State	:	NY
Zip	:	12518-0528
Country	:	US
Telephone Number	:	845-220-3144
Fax Number	:

Provider Business Practice Location Address
First Line	:	147 LAKE ST
Second Line	:
City	:	NEWBURGH
State	:	NY
Zip	:	12550-5242
Country	:	US
Telephone Number	:	845-563-8000
Fax Number	:	845-563-8087

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	05/12/2011

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