1568428043 NPI number — CYNTHIA CHAN SILE MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568428043 NPI number — CYNTHIA CHAN SILE MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SILE

Provider First Name:

CYNTHIA

Provider Middle Name:

CHAN

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1568428043

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

06/19/2018

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

6350 CENTER DR

Provider Second Line Business Mailing Address:

STE 200

Provider Business Mailing Address City Name:

NORFOLK

Provider Business Mailing Address State Name:

VA

Provider Business Mailing Address Postal Code:

23502-4107

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

757-213-5700

Provider Business Mailing Address Fax Number:

757-213-5762

Provider First Line Business Practice Location Address:

150 BURNETTS WAY

Provider Second Line Business Practice Location Address:

SUITE 310

Provider Business Practice Location Address City Name:

SUFFOLK

Provider Business Practice Location Address State Name:

VA

Provider Business Practice Location Address Postal Code:

23434-8168

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

757-539-0670

Provider Business Practice Location Address Fax Number:

757-539-1062

Provider Enumeration Date:

04/25/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207RH0003X , with the licence number:  MD073324L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207RH0003X , with the licence number: 0101058600 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 5767724 . This is a "AETNA PPOS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 1304723 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
• Identifier: 900003731 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 000000198810 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 000000119810 . This is a "UNISON/MEDPLUS" identifier . This identifiers is of the category "OTHER".
• Identifier: 0018579320001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 2295672 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
• Identifier: 0018579320002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 1568428043 . This is a "OPTIMA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
• Identifier: 3340403 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 1568428043 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".