1730477415 NPI number — DR. DANIEL SILITSKY PH.D., ED.S., CHT,

Table of content: DR. DANIEL SILITSKY PH.D., ED.S., CHT, (NPI 1730477415)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730477415 NPI number — DR. DANIEL SILITSKY PH.D., ED.S., CHT,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SILITSKY
Provider First Name:
DANIEL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D., ED.S., CHT,
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:
1730477415
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11 VAN HISE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST BRUNSWICK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08816-3439
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-718-3535
Provider Business Mailing Address Fax Number:
732-698-0335

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
197 ROUTE 18
Provider Second Line Business Practice Location Address:
SUITE 235
Provider Business Practice Location Address City Name:
EAST BRUNSWICK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08816-1440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-718-3535
Provider Business Practice Location Address Fax Number:
732-698-0335
Provider Enumeration Date:
07/15/2011

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: 101YP2500X , with the licence number:  6180055 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: 37FI00124400 , 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: 6180055 . This is a "PROFESSIONAL" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 37FI00124400 . This is a "NJ LICENSED MARRIAGE AND FAMILY THERAPIST" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0300-072447 . This is a "CERTIFIED HYPNOTHERAPIST" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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