Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 0101262307 | VA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 304024 | NY |
NPI | 1033439690 |
---|---|
Provider Name | Alexis Joanne Disilvestro |
First Address | Albany, NY 12212-4890 |
Second Address | Slingerlands, NY 12159-9276 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2010 |
Last Update Date | 11/05/2021 |