Healthcare Provider Details

I. General information

NPI: 1174783237
Provider Name (Legal Business Name): JASON M SILVERSTEEN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 09/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

774 CHRISTIANA ROAD SUITE 201
NEWARK DE
19713-0000
US

IV. Provider business mailing address

200 HYGEIA DRIVE SUITE 2502
NEWARK DE
19713-2049
US

V. Phone/Fax

Practice location:
  • Phone: 302-731-3017
  • Fax: 302-266-9960
Mailing address:
  • Phone: 302-623-7362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberOT011116
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: