Provider Demographics
NPI:1639132665
Name:D'SILVA, NOEL A (MD)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:A
Last Name:D'SILVA
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 1:1111 MONTAUK HWY
Mailing Address - Street 2:FL 33
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4910
Mailing Address - Country:US
Mailing Address - Phone:631-669-1171
Mailing Address - Fax:631-669-1912
Practice Address - Street 1:1175 MONTAUK HWY
Practice Address - Street 2:SUITE 3
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4939
Practice Address - Country:US
Practice Address - Phone:631-669-1171
Practice Address - Fax:631-669-1912
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY179727207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY34H271Medicare ID - Type Unspecified
NYC05286Medicare UPIN