Provider Demographics
NPI:1730105255
Name:D'SILVA, EWA (DPM)
Entity Type:Individual
Prefix:
First Name:EWA
Middle Name:
Last Name:D'SILVA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PUTTERS CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-3364
Mailing Address - Country:US
Mailing Address - Phone:718-720-8372
Mailing Address - Fax:718-720-1304
Practice Address - Street 1:10 PUTTERS CT
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-3364
Practice Address - Country:US
Practice Address - Phone:718-720-8372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNO051171213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01759140Medicaid
NYP12321Medicare ID - Type Unspecified
NY01759140Medicaid
NY5808920001Medicare NSC