Provider Demographics
NPI:1740294602
Name:SILVESTER, NANCY A (PA)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:SILVESTER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 RXR PLZ FL 13
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11556-1301
Mailing Address - Country:US
Mailing Address - Phone:516-453-0435
Mailing Address - Fax:646-846-3283
Practice Address - Street 1:1930 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-3328
Practice Address - Country:US
Practice Address - Phone:631-254-5900
Practice Address - Fax:631-392-0948
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014836363AM0700X, 363A00000X
VA0110001263363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008042V59Medicare PIN
Q45884Medicare UPIN
VA017239F25Medicare PIN
VAP00365972Medicare PIN