Provider Demographics
NPI:1568839132
Name:SILBER, ROSANNA SUSILA (DNP, CPNP-PC, RN)
Entity Type:Individual
Prefix:DR
First Name:ROSANNA
Middle Name:SUSILA
Last Name:SILBER
Suffix:
Gender:F
Credentials:DNP, CPNP-PC, RN
Other - Prefix:MS
Other - First Name:ROSANNA
Other - Middle Name:SUSILA
Other - Last Name:RYSKASEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP-PC, RN
Mailing Address - Street 1:1275 YORK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1275 YORK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6007
Practice Address - Country:US
Practice Address - Phone:212-639-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY382579363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics