Provider Demographics
NPI:1821662933
Name:PUMA, SILVIA MARISOL (MD)
Entity type:Individual
Prefix:
First Name:SILVIA
Middle Name:MARISOL
Last Name:PUMA
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 1:140 HAZARD AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-5424
Mailing Address - Country:US
Mailing Address - Phone:860-714-9733
Mailing Address - Fax:860-714-8136
Practice Address - Street 1:140 HAZARD AVE STE 105
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-5424
Practice Address - Country:US
Practice Address - Phone:860-714-9733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-14
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT77674207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine