Provider Demographics
NPI:1285773499
Name:SILVESTRO, MELISSA (OTRL)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:SILVESTRO
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:BIALOWASZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:235 BLUE POINT AVE
Mailing Address - Street 2:
Mailing Address - City:BLUE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11715-1261
Mailing Address - Country:US
Mailing Address - Phone:516-860-4477
Mailing Address - Fax:631-846-9440
Practice Address - Street 1:12 FAIRLANE DR
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-1717
Practice Address - Country:US
Practice Address - Phone:516-860-4477
Practice Address - Fax:631-846-9440
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011143225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics