1538763628 NPI number — DR. TAYLOR LILIA DASILVA PHARMD

Table of content: DR. TAYLOR LILIA DASILVA PHARMD (NPI 1538763628)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538763628 NPI number — DR. TAYLOR LILIA DASILVA PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DASILVA
Provider First Name:
TAYLOR
Provider Middle Name:
LILIA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

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 Information

NPI Number:
1538763628
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
57 JILLIAN WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTPORT
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02790-4231
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
548 DARTMOUTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH DARTMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02748-1908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-991-7934
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/30/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  239910 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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