Provider Demographics
NPI:1063955649
Name:SILVA, CRYSTAL ANN (MSW)
Entity type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:ANN
Last Name:SILVA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 PILLING ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-1610
Mailing Address - Country:US
Mailing Address - Phone:718-602-1000
Mailing Address - Fax:718-602-1111
Practice Address - Street 1:1150 S SEMORAN BLVD STE A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-1424
Practice Address - Country:US
Practice Address - Phone:407-704-7811
Practice Address - Fax:407-382-0659
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMM16744CMedicaid
NY537361700OtherPASSPORT NUMBER