Provider Demographics
NPI:1982743308
Name:SILVA, MARIA MANUELA (DC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:MANUELA
Last Name:SILVA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-3516
Mailing Address - Country:US
Mailing Address - Phone:908-558-1333
Mailing Address - Fax:908-558-0663
Practice Address - Street 1:364 S BROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-3516
Practice Address - Country:US
Practice Address - Phone:908-558-1333
Practice Address - Fax:908-558-0663
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2839111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJSI451901Medicare ID - Type Unspecified