Disilva, Mary L

Disilva, Mary L is an individual health care provider with primary practice located at 3400 Spruce St 3 Silverstein, Philadelphia PA 19104-4206. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Disilva, Mary L can be contacted via phone (215) 662-4000.

Contact Information

Primary practice address
3400 Spruce St 3 Silverstein Philadelphia PA 19104-4206
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X SP007091 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X SP008809 Pennsylvania

Profile Details

NPI number 1124094016
LBN Legal business name Disilva, Mary L
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated May 10th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124094016 NPPES
Ohio Other NP05308 OHIO NP LICENSE
Ohio Other 265946 OHIO NP LICENSE

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