Provider Demographics
NPI:1568475051
Name:DASILVA, JOHN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:DASILVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HEBRON AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2192
Mailing Address - Country:US
Mailing Address - Phone:860-522-1024
Mailing Address - Fax:860-278-4613
Practice Address - Street 1:300 HEBRON AVE STE 211
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2192
Practice Address - Country:US
Practice Address - Phone:860-522-1024
Practice Address - Fax:860-278-4613
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT027296208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0528373OtherAETNA
CT010027296CT03OtherANTHEM BLUE CROSS
CT0P0272OtherHEALTH NET
CT0528373OtherUS HEALTHCARE
CT1272962Medicaid
CT01027296OtherCIGNA
CT060886963OtherUNITED HEALTHCARE
CT00127296200OtherBLUE CARE FAMILY PLAN
CT786963OtherCONNECTICARE
CTHAS500OtherOXFORD
CT0528373OtherUS HEALTHCARE
CT786963OtherCONNECTICARE
020009842Medicare PIN