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General NPI Number Information
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NPI Number | 1013104660
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Entity Type | Individual
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Provider Name | BETH MARA SILVERSTEIN DO
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Gender | Female
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 11/13/2012
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Provider Practice Location Address
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Address Line | 10 MEDICAL PLZ SUITE 208
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City | GLEN COVE
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State | NY
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Zip | 11542-2101
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Country | US
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Telephone | 516-674-1647
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Fax | 516-674-9250
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Provider Business Mailing Address
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Address Line | 300 EDWARDS ST APT. 2LW
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-1140
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Country | US
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Telephone | 917-282-1489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 261123
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 261123
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License Number State | NY
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