1629091756 NPI number — DANIEL SILVERMAN LCSW, C-ACYFSW

Table of content: DANIEL SILVERMAN LCSW, C-ACYFSW (NPI 1629091756)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629091756 NPI number — DANIEL SILVERMAN LCSW, C-ACYFSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SILVERMAN
Provider First Name:
DANIEL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW, C-ACYFSW
Provider Gender Code:
M

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:
1629091756
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
532 BRETTS WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITESBORO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13492-3210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-717-7080
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310 E CHESTNUT ST
Provider Second Line Business Practice Location Address:
SUITE NUMBER 9
Provider Business Practice Location Address City Name:
ROME
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13440-3660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-717-7080
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/26/2006

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: 1041C0700X , with the licence number:  R049489-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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