National Provider Identifier

Audrey H Desilva, MD

Audrey H Desilva, MD is listed in the NPPES registry with a primary specialty of Pediatrics Physician in Ithaca, NY and a listed phone number of (607) 257-2188.

NPI 1356323133Ithaca, NYPediatrics Physician

Profile Overview

NPI
1356323133
Provider Type
Individual
Primary Specialty
Pediatrics Physician
Enumeration Date
November 16, 2005
Last Updated
July 08, 2007

Practice Location

  • 10 Graham RD W
  • Ithaca, NY 14850-1055

Phone: (607) 257-2188

Specialties

  • Pediatrics Physician (208000000X)
Full Record
NPI
1356323133
Entity Type
Individual
Last Name
Desilva
First Name
Audrey
Middle Name
H
Credential
MD
Mailing Street Address
10 Graham RD W
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850-1055
Mailing Country
US
Mailing Phone
(607) 257-2188
Mailing Fax
(607) 266-7341
Practice Street Address
10 Graham RD W
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-1055
Practice Country
US
Practice Phone
(607) 257-2188
Practice Fax
(607) 266-7341
Enumeration Date
November 16, 2005
Last Updated
July 08, 2007
Sex
Female
Sole Proprietor
X
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Pediatrics Physician (208000000X)
Other Identifiers
V018315 (Tricare), 000910782001 (Healthnow), 5677620 (Aetna Managed Choice), 6477 (NY, Total Care/Managed Ma), 01868340 (NY)