1427292028 NPI number — NIKI SILVERSTEIN EYE MD LLC

Table of content: (NPI 1427292028)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427292028 NPI number — NIKI SILVERSTEIN EYE MD LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NIKI SILVERSTEIN EYE MD LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1427292028
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
408 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESTER
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07930-2541
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-879-7297
Provider Business Mailing Address Fax Number:
908-879-4798

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
408 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHESTER
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07930-2541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-879-7297
Provider Business Practice Location Address Fax Number:
908-879-4798
Provider Enumeration Date:
04/27/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ARIAS
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL BILLER
Authorized Official Telephone Number:
908-879-7297

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  25MA03981200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1669478731 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".