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NPI Code Detail

MEDICARE: DR. JENNIBA SILLA PHARMD

MEDICARE: DR. JENNIBA SILLA PHARMD
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
1183500000XPharmacist048801NY

General Provider Information

NPI Number : 1366764169
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIBA SILLA PHARMD
Provider Business Mailing Address
First Line : 1535 E 45TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-3005
Country : US
Telephone Number : 917-541-2458
Fax Number :
Provider Business Practice Location Address
First Line : 10202 FLATLANDS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-2810
Country : US
Telephone Number : 718-257-1099
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2010
Last Update Date : 02/19/2010

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