Provider Demographics
NPI:1891808754
Name:DAMBROSIO, SILVIA (MD)
Entity Type:Individual
Prefix:
First Name:SILVIA
Middle Name:
Last Name:DAMBROSIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SILVIA
Other - Middle Name:
Other - Last Name:PAGANELLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1452 E 98TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5044
Mailing Address - Country:US
Mailing Address - Phone:718-826-5911
Mailing Address - Fax:718-826-5860
Practice Address - Street 1:1452 E 98TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-5044
Practice Address - Country:US
Practice Address - Phone:718-531-0055
Practice Address - Fax:718-531-0065
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD164553207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01098159Medicaid
NY18E131Medicare PIN