Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N004464 | NY |
NPI | 1336213693 |
---|---|
Provider Name | Dr. Carlos Fredy Silva |
First Address | Woodhaven, NY 11421-1535 |
Second Address | Woodhaven, NY 11421-1535 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 08/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01094664 | (05) | NY |
164299 | ELDERPLAN (01) | NY |
36909P | HIP (01) | NY |
P1884071 | OXFORD MEDICARE ID (01) | NY |
T81577 | (02) | NY |