Provider Demographics
NPI:1265460216
Name:CARDENAS-CROWLEY, SILVIA O (MD)
Entity type:Individual
Prefix:
First Name:SILVIA
Middle Name:O
Last Name:CARDENAS-CROWLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3196 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-2436
Mailing Address - Country:US
Mailing Address - Phone:833-617-0501
Mailing Address - Fax:886-319-8276
Practice Address - Street 1:3196 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-2436
Practice Address - Country:US
Practice Address - Phone:833-617-0501
Practice Address - Fax:886-319-8276
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05234800207R00000X
NY161555207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01106638Medicaid
NY12F161Medicare PIN
NY01106638Medicaid