1194372540 NPI number — MRS. VIRGINIA MARY SILVER LCSW

Table of content: MRS. VIRGINIA MARY SILVER LCSW (NPI 1194372540)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194372540 NPI number — MRS. VIRGINIA MARY SILVER LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SILVER
Provider First Name:
VIRGINIA
Provider Middle Name:
MARY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BRAND
Provider Other First Name:
VIRGINIA
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1194372540
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/21/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
349 MILLER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREEPORT
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11520-6112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-401-5534
Provider Business Mailing Address Fax Number:
631-385-5956

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
349 MILLER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREEPORT
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11520-6112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-401-5534
Provider Business Practice Location Address Fax Number:
631-385-5956
Provider Enumeration Date:
08/21/2019

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:  039194 , 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)





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