MEDICARE: DR. FARRELL R. SILVERBERG PH.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	102L00000X	Psychoanalyst	000800	NY
2	103TP0814X	Psychoanalysis Psychologist	01025	NY
3	103TP0814X	Psychoanalysis Psychologist	4478L	PA

General Provider Information

NPI Number	:	1659594778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FARRELL R. SILVERBERG PH.D.

Provider Business Mailing Address
First Line	:	2024 LOCUST ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-5614
Country	:	US
Telephone Number	:	215-545-1096
Fax Number	:

Provider Business Practice Location Address
First Line	:	2024 LOCUST ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-5614
Country	:	US
Telephone Number	:	215-545-1096
Fax Number	:

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

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	11/01/2019

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