Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 40722 | MA |
NPI | 1013978030 |
---|---|
Provider Name | Jorge E Silva |
First Address | Springfield, MA 01107-1108 |
Second Address | Southwick, MA 01077-9690 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2006 |
Last Update Date | 05/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110000496B | (05) | MA |
E05209 | BCBS (01) | MA |