Provider Demographics
NPI:1487730438
Name:OBICI, SILVANA (MD)
Entity type:Individual
Prefix:
First Name:SILVANA
Middle Name:
Last Name:OBICI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1554
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0988
Mailing Address - Country:US
Mailing Address - Phone:613-444-0650
Mailing Address - Fax:631-638-4170
Practice Address - Street 1:26 RESEARCH WAY
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3526
Practice Address - Country:US
Practice Address - Phone:631-444-0580
Practice Address - Fax:631-444-9808
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211554-1207RE0101X
OH35.088665207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2728409Medicaid
IN200851720Medicaid
KY7100022360Medicaid
KY7100022360Medicaid