Provider Demographics
NPI:1952897100
Name:DASILVA, PETER J (EDD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:J
Last Name:DASILVA
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1288
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-1288
Mailing Address - Country:US
Mailing Address - Phone:413-222-7257
Mailing Address - Fax:
Practice Address - Street 1:40 WOODHAVEN DRIVE
Practice Address - Street 2:
Practice Address - City:BELCHERTOWN
Practice Address - State:MA
Practice Address - Zip Code:01007-1288
Practice Address - Country:US
Practice Address - Phone:413-222-7257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4888-PY-PR103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist