1013096114 NPI number — MR. ANDREW PAUL SILVERMAN RPH

Table of content: MR. ANDREW PAUL SILVERMAN RPH (NPI 1013096114)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013096114 NPI number — MR. ANDREW PAUL SILVERMAN RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SILVERMAN
Provider First Name:
ANDREW
Provider Middle Name:
PAUL
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
RPH
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:
1013096114
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
28 SARATOGA DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JERICHO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11753
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-318-0196
Provider Business Mailing Address Fax Number:
718-589-6742

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1515 SOUTHERN BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10460-5980
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-861-5490
Provider Business Practice Location Address Fax Number:
718-861-5493
Provider Enumeration Date:
11/02/2006

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: 183500000X , with the licence number:  039832 , 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)

  • Identifier: 039832 . This is a "NEW YORK STATE LISC #" identifier . This identifiers is of the category "OTHER".




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