1477004430 NPI number — NANETTE B. SILVERBERG MD PLLC

Table of content: (NPI 1477004430)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477004430 NPI number — NANETTE B. SILVERBERG MD PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NANETTE B. SILVERBERG MD PLLC
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:
1477004430
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/14/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26 FIREMENS MEMORIAL DR
Provider Second Line Business Mailing Address:
SUITE 115
Provider Business Mailing Address City Name:
POMONA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10970-3553
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-362-8400
Provider Business Mailing Address Fax Number:
845-362-8474

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2839 BRIGHTON 7TH ST
Provider Second Line Business Practice Location Address:
1ST FLOOR
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11235-5203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-332-0270
Provider Business Practice Location Address Fax Number:
718-332-1318
Provider Enumeration Date:
10/14/2016

Additional Information

Authorized Official

Authorized Official Last Name:
MCKENNA
Authorized Official First Name:
KRYSTAL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
800-750-8616

Provider Taxonomy Codes

  • Taxonomy code: 207NP0225X , with the licence number:  202174 , 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: 202174 . This is a "STATE LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com