Healthcare Provider Details

I. General information

NPI: 1316933740
Provider Name (Legal Business Name): NANETTE B SILVERBERG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 04/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 UNION SQ E SUITE 3C
NEW YORK NY
10003-3314
US

IV. Provider business mailing address

770 OCEAN PKWY APT 6F
BROOKLYN NY
11230-2158
US

V. Phone/Fax

Practice location:
  • Phone: 212-844-8800
  • Fax:
Mailing address:
  • Phone: 718-332-0270
  • Fax: 718-332-1318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License Number202174
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number2021741
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: