Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | 243375 | NY |
Y | 207QA0505X | Family Doctor - Adult Medicine | 243375 | NY |
NPI | 1336269802 |
---|---|
Provider Name | Silas Nwaishienyi |
First Address | Westbury, NY 11590-1208 |
Second Address | Westbury, NY 11590-1208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2007 |
Last Update Date | 22/06/2013 |