Individual
MARYLOU SILVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
326 WASHINGTON ST, NORWICH, CT 06360-2740
(860) 889-8331
(860) 892-6926
Mailing address
20 CATAMORE BLVD, EAST PROVIDENCE, RI 02914-1204
(401) 432-2520
(401) 432-2457
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
PA00235
RI
363AS0400X
Surgical Physician Assistant
Primary
3909
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
275938
BLUECHIP
—
01
—
9003558
RIMEDICALASSISTANCE
—
Enumeration date
10/13/2005
Last updated
07/21/2022
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