Provider Demographics
NPI:1760864714
Name:SILIE, DANEISY (LMT)
Entity Type:Individual
Prefix:
First Name:DANEISY
Middle Name:
Last Name:SILIE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 MIDDLE COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:11953-2505
Mailing Address - Country:US
Mailing Address - Phone:631-538-0115
Mailing Address - Fax:
Practice Address - Street 1:285 MIDDLE COUNTRY RD
Practice Address - Street 2:
Practice Address - City:MIDDLE ISLAND
Practice Address - State:NY
Practice Address - Zip Code:11953-2505
Practice Address - Country:US
Practice Address - Phone:631-538-0115
Practice Address - Fax:631-296-0111
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
NY031842-01225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator