MEDICARE: TARA SILVA CPHT

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	183700000X	Pharmacy Technician	2101-1301-9769-495	NY

General Provider Information

NPI Number	:	1609089572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA SILVA CPHT

Provider Business Mailing Address
First Line	:	554 E 141ST ST
Second Line	:	APT 2
City	:	BRONX
State	:	NY
Zip	:	10454-2107
Country	:	US
Telephone Number	:	646-257-9487
Fax Number	:

Provider Business Practice Location Address
First Line	:	554 E 141ST ST
Second Line	:	APT 2
City	:	BRONX
State	:	NY
Zip	:	10454-2107
Country	:	US
Telephone Number	:	646-257-9487
Fax Number	:

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	07/08/2007

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