Provider Demographics
NPI:1053674671
Name:DUTRUEL, SILVINA PAOLA (MD)
Entity Type:Individual
Prefix:
First Name:SILVINA
Middle Name:PAOLA
Last Name:DUTRUEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E 68TH ST # 153
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-4870
Mailing Address - Country:US
Mailing Address - Phone:212-746-4580
Mailing Address - Fax:212-746-9010
Practice Address - Street 1:525 E 68TH ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-4580
Practice Address - Fax:212-746-9010
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286508-1207UN0902X, 2085B0100X, 2085N0904X
NY286508207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine