NPI: 1447221627 · PORT JERVIS, NY 12771 · Dental Clinic/Center · NPI assigned 01/27/2006
| Authorized Official | DE SILVA, SUJATHA (PRINCIPAL) |
| NPI Enumeration Date | 01/27/2006 |
Other providers sharing the same authorized official: DE SILVA, SUJATHA
| Provider | City | State | Total Paid |
|---|---|---|---|
| SUJATHA H DE SILVA DDS PC | STATEN ISLAND | NY | $2K |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 13 | $317.50 |
| 2022 | 49 | $1K |