Healthcare Provider Details

I. General information

NPI: 1891782165
Provider Name (Legal Business Name): ERIC W SILVERSTEIN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 SEYMOUR ST SUITE 409
HARTFORD CT
06106-5501
US

IV. Provider business mailing address

85 SEYMOUR ST SUITE 409
HARTFORD CT
06106-5501
US

V. Phone/Fax

Practice location:
  • Phone: 860-547-0616
  • Fax: 860-524-2655
Mailing address:
  • Phone: 860-547-0616
  • Fax: 860-524-2655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number000538
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number000538
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License Number000538
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number000538
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: