Healthcare Provider Details

I. General information

NPI: 1952693160
Provider Name (Legal Business Name): AYAKA MAEDA SILVERMAN M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E ERIE AVE
PHILADELPHIA PA
19134-1011
US

IV. Provider business mailing address

160 E ERIE AVE
PHILADELPHIA PA
19134-1011
US

V. Phone/Fax

Practice location:
  • Phone: 215-427-5272
  • Fax: 215-427-4284
Mailing address:
  • Phone: 215-427-5272
  • Fax: 215-427-4284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD462395
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: