Provider Demographics
NPI:1518146240
Name:SILVA, KRISTINE MAE (OT)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:MAE
Last Name:SILVA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:MAE
Other - Last Name:BAUTISTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:2328 UNIVERSITY AVE
Mailing Address - Street 2:APT. #1S
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-6249
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2328 UNIVERSITY AVE
Practice Address - Street 2:APT. #1S
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-6249
Practice Address - Country:US
Practice Address - Phone:212-221-1544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014477-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist