Provider Demographics
NPI:1194932475
Name:SILVESTRE, JOAO VIEIRA (MS, LCSW)
Entity type:Individual
Prefix:MR
First Name:JOAO
Middle Name:VIEIRA
Last Name:SILVESTRE
Suffix:
Gender:M
Credentials:MS, LCSW
Other - Prefix:
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Mailing Address - Street 1:680 W END AVE
Mailing Address - Street 2:SUITE #1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6815
Mailing Address - Country:US
Mailing Address - Phone:212-362-5413
Mailing Address - Fax:212-362-5413
Practice Address - Street 1:680 W END AVE
Practice Address - Street 2:SUITE #1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6815
Practice Address - Country:US
Practice Address - Phone:212-362-5413
Practice Address - Fax:212-362-5413
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYR042655-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN2I511Medicare PIN