Individual
TANIYA N DE SILVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 856-5881
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(508) 856-5881
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
228497
MA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
228497
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2156083
—
MA
Enumeration date
07/07/2006
Last updated
12/06/2010
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