MEDICARE: ROBERT JOSEPH DESILVA DO

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	390200000X	Student in an Organized Health Care Education/Training Program		MA

General Provider Information

NPI Number	:	1891634853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT JOSEPH DESILVA DO

Provider Business Mailing Address
First Line	:	35 RYAN FARM RD
Second Line	:
City	:	WINDHAM
State	:	NH
Zip	:	03087-1849
Country	:	US
Telephone Number	:	631-766-1030
Fax Number	:

Provider Business Practice Location Address
First Line	:	736 CAMBRIDGE ST
Second Line	:
City	:	BRIGHTON
State	:	MA
Zip	:	02135-2907
Country	:	US
Telephone Number	:	617-789-3000
Fax Number	:

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

Provider Enumeration Date	:	03/26/2026
Last Update Date	:	03/26/2026

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