Provider Demographics
NPI:1396353132
Name:SILVA, CAMILLE ELENA BREWSTER (OD)
Entity type:Individual
Prefix:DR
First Name:CAMILLE
Middle Name:ELENA BREWSTER
Last Name:SILVA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CAMILLE
Other - Middle Name:ELENA
Other - Last Name:BREWSTER DA SILVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:128 GAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5825
Mailing Address - Country:US
Mailing Address - Phone:914-874-3984
Mailing Address - Fax:
Practice Address - Street 1:33 W 42ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-8005
Practice Address - Country:US
Practice Address - Phone:212-938-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV009275152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist