Provider Demographics
NPI:1982938544
Name:SILVA, NELSON R
Entity type:Individual
Prefix:DR
First Name:NELSON
Middle Name:R
Last Name:SILVA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WATERSIDE PLZ APT 15A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-2690
Mailing Address - Country:US
Mailing Address - Phone:646-250-9790
Mailing Address - Fax:
Practice Address - Street 1:418 LAFAYETTE ST APT 350
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6956
Practice Address - Country:US
Practice Address - Phone:212-443-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000008-11223G0001X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No1223G0001XDental ProvidersDentistGeneral Practice