Healthcare Provider Details

I. General information

NPI: 1720134794
Provider Name (Legal Business Name): MARC M SILVERMAN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 11/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 WESTCHESTER AVE SUITE:LL3
BRONX NY
10461-4500
US

IV. Provider business mailing address

3250 WESTCHESTER AVE SUITE:LL3
BRONX NY
10461-4500
US

V. Phone/Fax

Practice location:
  • Phone: 718-409-0673
  • Fax: 718-409-3486
Mailing address:
  • Phone: 718-409-0673
  • Fax: 718-409-3486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number167766
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number167766
License Number StateNY

VIII. Authorized Official

Name: MARC M SILVERMAN
Title or Position: MD
Credential: MD
Phone: 718-409-0673