Provider Demographics
NPI:1043666803
Name:SILVA HEALTHCARE DIVISION
Entity Type:Organization
Organization Name:SILVA HEALTHCARE DIVISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMIC DISPENSER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:JR
Authorized Official - Credentials:LDO
Authorized Official - Phone:305-978-5683
Mailing Address - Street 1:PO BOX 746
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-0746
Mailing Address - Country:US
Mailing Address - Phone:305-978-5683
Mailing Address - Fax:
Practice Address - Street 1:81 TOWN GREEN DR
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-2315
Practice Address - Country:US
Practice Address - Phone:305-978-5683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009867332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier