Provider Demographics
NPI:1396330692
Name:SILVIS, GERTRUDE M
Entity type:Individual
Prefix:
First Name:GERTRUDE
Middle Name:M
Last Name:SILVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 VALLEY FORGE CIR
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-4540
Mailing Address - Country:US
Mailing Address - Phone:440-865-8917
Mailing Address - Fax:
Practice Address - Street 1:174 VALLEY FORGE CIR
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-4540
Practice Address - Country:US
Practice Address - Phone:440-865-8917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child