Provider Demographics
NPI:1801147988
Name:DA SILVA, PRISCILA DE FREITAS (MSED)
Entity type:Individual
Prefix:MRS
First Name:PRISCILA
Middle Name:DE FREITAS
Last Name:DA SILVA
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 115TH STREET
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-1535
Mailing Address - Country:US
Mailing Address - Phone:347-622-2128
Mailing Address - Fax:
Practice Address - Street 1:1227 115TH ST
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-1535
Practice Address - Country:US
Practice Address - Phone:347-622-2128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242700081174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist