Basic Information
| Provider Information | |||||||||
| NPI: | 1568575876 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SILVIA | ||||||||
| FirstName: | JOANNE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 362 N BEDFORD ST | ||||||||
| Address2: | |||||||||
| City: | E BRIDGEWATER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023331148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7742609300 | ||||||||
| FaxNumber: | 7742609305 | ||||||||
| Practice Location | |||||||||
| Address1: | 8 COMMERCE BLVD | ||||||||
| Address2: | |||||||||
| City: | MIDDLEBORO | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023461030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7742609300 | ||||||||
| FaxNumber: | 7742609305 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2006 | ||||||||
| LastUpdateDate: | 09/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 230677 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | LP00142 | RI | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000210904 | 01 | MA | MEDICARE PTAN | OTHER |