Provider Demographics
NPI:1770113383
Name:DA SILVA, MONICA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
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 1:3 VAL SUMO LN
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-3547
Mailing Address - Country:US
Mailing Address - Phone:973-277-3203
Mailing Address - Fax:
Practice Address - Street 1:3 VAL SUMO LN
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-3547
Practice Address - Country:US
Practice Address - Phone:973-277-3203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00990800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist