Basic Information
Provider Information
NPI: 1770990244
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GRES
FirstName: SILVIA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 83 SAINT JOHNS PL
Address2:  
City: NEW ROCHELLE
State: NY
PostalCode: 108014830
CountryCode: US
TelephoneNumber: 9145769394
FaxNumber:  
Practice Location
Address1: 170 MAPLE AVE
Address2: 309
City: WHITE PLAINS
State: NY
PostalCode: 106014710
CountryCode: US
TelephoneNumber: 9142200283
FaxNumber: 9142200288
Other Information
ProviderEnumerationDate: 07/16/2014
LastUpdateDate: 07/16/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XF336607-1NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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