Provider Demographics
NPI:1578810933
Name:JOSE, SILVY KURIAN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:SILVY
Middle Name:KURIAN
Last Name:JOSE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 OLD TOWN RD
Mailing Address - Street 2:STATEN ISLAND
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-4212
Mailing Address - Country:US
Mailing Address - Phone:718-761-7421
Mailing Address - Fax:
Practice Address - Street 1:230 BYRNE AVE
Practice Address - Street 2:STATEN ISLAND
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4409
Practice Address - Country:US
Practice Address - Phone:718-761-7421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-04
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340855363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology