Individual provider Active NPI

Marian O Dasilva, FNP

  • Family Nurse Practitioner
  • Bridgeton, NJ
National Provider Identifier
1740760180
Registry record updated Mar 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
342574 Issued in NY
Practice address
11 Neil CT
Bridgeton, NJ 08302-3617
Phone
(347) 524-5077
NPI assigned
Aug 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 342574 NY Primary
Registered Nurse 163W00000X 485068 NY

Addresses

Primary practice location

11 Neil CT
Bridgeton, NJ 08302-3617

Mailing address

11 Neil CT
Bridgeton, NJ 08302-3617
Phone (347) 524-5077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
485068NYMDRegistered Nurse
342574NYMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677974400000",
    "number": "1740760180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 NEIL CT",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083023617",
            "telephone_number": "347-524-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 NEIL CT",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083023617",
            "telephone_number": "347-524-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASILVA",
        "first_name": "MARIAN",
        "middle_name": "O",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2023-03-05",
        "certification_date": "2023-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342574",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "485068",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.