Provider Demographics
NPI:1356540579
Name:SILVA, MARIE ELAINE (LPN)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:ELAINE
Last Name:SILVA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 LE ROY LANE
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564
Mailing Address - Country:US
Mailing Address - Phone:914-519-8624
Mailing Address - Fax:
Practice Address - Street 1:36 LE ROY LA.
Practice Address - Street 2:
Practice Address - City:PAWLING
Practice Address - State:NY
Practice Address - Zip Code:12564
Practice Address - Country:US
Practice Address - Phone:914-519-8624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYU136431164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01171186Medicaid