Basic Information
Provider Information
NPI: 1831751874
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SILVA
FirstName: MELANIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 301 LIPPINCOTT DR STE 410
Address2:  
City: MARLTON
State: NJ
PostalCode: 080534197
CountryCode: US
TelephoneNumber: 8567573500
FaxNumber: 8563654088
Practice Location
Address1: 1600 HADDON AVE FL 6
Address2:  
City: CAMDEN
State: NJ
PostalCode: 08103
CountryCode: US
TelephoneNumber: 8567573500
FaxNumber: 8563654088
Other Information
ProviderEnumerationDate: 06/29/2019
LastUpdateDate: 09/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/15/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X25MB11223200NJY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


Home