Healthcare Provider Details

I. General information

NPI: 1609874916
Provider Name (Legal Business Name): LAWRENCE SILVERBERG DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: LAWRENCE SILVERBERG DPM

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 05/16/2020
Certification Date: 05/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 EAST 46TH ST 200
NEW YORK NY
10017-9287
US

IV. Provider business mailing address

20 EAST 46TH ST 200
NEW YORK NY
10017-9287
US

V. Phone/Fax

Practice location:
  • Phone: 212-871-0800
  • Fax: 206-203-3026
Mailing address:
  • Phone: 212-871-0800
  • Fax: 206-203-3026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN005652
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN005652-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: