Provider Demographics
NPI:1255379715
Name:SILVESTRE, PRISCILA ALFONSO (RD)
Entity type:Individual
Prefix:MISS
First Name:PRISCILA
Middle Name:ALFONSO
Last Name:SILVESTRE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BEDFORD AVE
Mailing Address - Street 2:BUILDING 2 APT.2
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3857
Mailing Address - Country:US
Mailing Address - Phone:203-852-2304
Mailing Address - Fax:203-852-2018
Practice Address - Street 1:14 BEDFORD AVE
Practice Address - Street 2:BUILDING 2 APT.2
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3857
Practice Address - Country:US
Practice Address - Phone:203-852-2304
Practice Address - Fax:203-852-2018
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000242133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered