Healthcare Provider Details

I. General information

NPI: 1336108422
Provider Name (Legal Business Name): WENDY BETH SILVERSTEIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 N VAN DIEN AVE
RIDGEWOOD NJ
07450-2726
US

IV. Provider business mailing address

135 ORCHARD RD
DEMAREST NJ
07627-1716
US

V. Phone/Fax

Practice location:
  • Phone: 201-847-9403
  • Fax: 201-847-0059
Mailing address:
  • Phone: 201-784-1615
  • Fax: 201-784-1615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA06798000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: