Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 15860 | MD |
N | 1223G0001X | General Practice | 053415 | NY |
N | 213EG0000X | General Practice | 053415 | NY |
NPI | 1679787220 |
---|---|
Provider Name | Dr. Monica F Tiu Silva |
First Address | Derwood, MD 20855-1620 |
Second Address | Largo, MD 20774-5338 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 15/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03079921 | (05) | NY |