MEDICARE: SUSANNA SILVERMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0201X	Allergy & Immunology (Internal Medicine) Physician	264092	NY
2	207R00000X	Internal Medicine Physician	264092	NY

General Provider Information

NPI Number	:	1104050129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSANNA SILVERMAN M.D.

Provider Business Mailing Address
First Line	:	381 PARK AVE S
Second Line	:	SUITE 1020
City	:	NEW YORK
State	:	NY
Zip	:	10016-8806
Country	:	US
Telephone Number	:	212-260-6078
Fax Number	:	212-260-6185

Provider Business Practice Location Address
First Line	:	381 PARK AVE S
Second Line	:	SUITE 1020
City	:	NEW YORK
State	:	NY
Zip	:	10016-8806
Country	:	US
Telephone Number	:	212-260-6078
Fax Number	:	212-260-6185

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2009
Last Update Date	:	02/04/2016

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