Individual
DR. SILVIA FANNY LARA-MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PA
Contact information
Practice address
925 N 87TH ST, MILWAUKEE, WI 53226-4812
(414) 955-2020
(414) 955-6300
Mailing address
925 N 87TH ST, MILWAUKEE, WI 53226-4812
(414) 955-2020
(414) 955-6300
Taxonomy
Speciality
Code
Description
License number
State
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
3279381
ZZ
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
85462-875
WI
363A00000X
Physician Assistant
001620-P.A.
PR
363AM0700X
Medical Physician Assistant
001620-P.A.
PR
363AS0400X
Surgical Physician Assistant
001620-P.A.
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366126468
—
WI
Enumeration date
06/09/2023
Last updated
04/16/2025
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