MEDICARE: SILVIA CALDERON

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	1223G0001X	General Practice Dentistry	059857	NY

General Provider Information

NPI Number	:	1457890444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SILVIA CALDERON

Provider Business Mailing Address
First Line	:	200 CLINTON ST APT 1B
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5622
Country	:	US
Telephone Number	:	786-546-4089
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 CLINTON ST APT 1B
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5622
Country	:	US
Telephone Number	:	786-546-4089
Fax Number	:

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

Provider Enumeration Date	:	02/23/2017
Last Update Date	:	01/02/2024

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Directions to “ SILVIA CALDERON ” Practice Location

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