Provider Demographics
NPI:1215003512
Name:SILTON, SHIRA ALIZA
Entity Type:Individual
Prefix:MISS
First Name:SHIRA
Middle Name:ALIZA
Last Name:SILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 W END AVE
Mailing Address - Street 2:APT 5F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6230
Mailing Address - Country:US
Mailing Address - Phone:646-932-0974
Mailing Address - Fax:
Practice Address - Street 1:871 PROSPECT AVENUE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459
Practice Address - Country:US
Practice Address - Phone:718-991-0605
Practice Address - Fax:718-991-2931
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073249-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker