Provider Demographics
NPI:1629120936
Name:SILAO, NICHOLAS (CRNA)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:SILAO
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 CENTRAL PARK S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1629
Mailing Address - Country:US
Mailing Address - Phone:917-597-0082
Mailing Address - Fax:212-629-9330
Practice Address - Street 1:38 W 32ND ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3816
Practice Address - Country:US
Practice Address - Phone:212-629-8181
Practice Address - Fax:212-629-9330
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR08985200367500000X
NY343627367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR3A421Medicare ID - Type Unspecified
NJ880336Medicare ID - Type Unspecified