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General NPI Number Information
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NPI Number | 1437603776
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Entity Type | Individual
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Provider Name | JORDAN MICHAEL SILIDKER PA
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Gender | Male
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Dates
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Enumeration Date | 08/03/2016
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Last Update Date | 03/22/2017
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Provider Practice Location Address
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Address Line | 80 SEYMOUR STREET HARTFORD HOSPITAL SURGERY DEPT.
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City | HARTFORD
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State | CT
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Zip | 06102-5037
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Country | US
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Telephone | 860-972-5022
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Fax |
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Provider Business Mailing Address
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Address Line | 80 SEYMOUR STREET HARTFORD HOSPITAL SURGERY DEPT.
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City | HARTFORD
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State | CT
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Zip | 06102-5037
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Country | US
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Telephone | 860-972-5022
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 003688
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 003688
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 003688
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License Number State | CT
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