Provider Demographics
NPI:1205714912
Name:DA SILVA, ISABELLE SUFFI
Entity type:Individual
Prefix:
First Name:ISABELLE
Middle Name:SUFFI
Last Name:DA SILVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-1348
Mailing Address - Country:US
Mailing Address - Phone:856-581-3785
Mailing Address - Fax:
Practice Address - Street 1:500 GROVE ST STE 100
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1761
Practice Address - Country:US
Practice Address - Phone:856-617-0175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02361800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist