Healthcare Provider Details

I. General information

NPI: 1831203991
Provider Name (Legal Business Name): WARREN SILVERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 08/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

776A WATERVLIET SHAKER RD
LATHAM NY
12110-2209
US

IV. Provider business mailing address

776A WATERVLIET SHAKER RD
LATHAM NY
12110-2209
US

V. Phone/Fax

Practice location:
  • Phone: 518-782-2200
  • Fax: 518-786-1875
Mailing address:
  • Phone: 518-782-2200
  • Fax: 518-786-1875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number162940
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number162940-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number162940-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: