Individual
NICOLE MARIE SILVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-4000
Mailing address
901 N PENN ST UNIT P1905, PHILADELPHIA, PA 19123-3275
(209) 743-1950
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA060304
PA
363AS0400X
Surgical Physician Assistant
OA004677
PA
Other
Enumeration date
10/25/2018
Last updated
10/25/2018
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