Provider Demographics
NPI:1144224130
Name:SILVA, JOSE VICENTE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:VICENTE
Last Name:SILVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:425 W 59TH ST
Mailing Address - Street 2:FL 3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1104
Mailing Address - Country:US
Mailing Address - Phone:212-582-3421
Mailing Address - Fax:212-765-6250
Practice Address - Street 1:425 W 59TH ST
Practice Address - Street 2:FL 3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1104
Practice Address - Country:US
Practice Address - Phone:212-582-3421
Practice Address - Fax:212-765-6250
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY140160208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00591144Medicaid
NYC10272Medicare UPIN
NY00591144Medicaid