MEDICARE: JACQUELINE SILVA MSED

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	174H00000X	Health Educator		NY

General Provider Information

NPI Number	:	1952684953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE SILVA MSED

Provider Business Mailing Address
First Line	:	1042 COLGATE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-5506
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1042 COLGATE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-5506
Country	:	US
Telephone Number	:	917-478-1771
Fax Number	:

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

Provider Enumeration Date	:	09/26/2011
Last Update Date	:	09/26/2011

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Directions to “ JACQUELINE SILVA MSED” Practice Location

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