Provider Demographics
NPI:1588609143
Name:SILENZIO, VINCENT M B (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:M B
Last Name:SILENZIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX:PSYCH
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-279-4600
Mailing Address - Fax:585-276-0161
Practice Address - Street 1:777 S CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-1401
Practice Address - Country:US
Practice Address - Phone:585-279-4600
Practice Address - Fax:585-279-4605
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2011-04-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY208868207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01886846Medicaid
NYDD3001Medicare PIN
NYG12818Medicare UPIN