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General NPI Number Information
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NPI Number | 1477727873
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Entity Type | Organization
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Legal Business Name | JEFFERSON HEADACHE CENTER
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 111 S 11TH ST SUITE 8130
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4824
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Country | US
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Telephone | 215-955-2243
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Fax | 215-955-1960
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Provider Business Mailing Address
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Address Line | 111 S 11TH ST SUITE 8130
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4824
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Country | US
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Telephone | 215-955-2243
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Fax | 215-955-1960
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. STEPHEN DAVID SILBERSTEIN
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Credential | MD
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Telephone | 215-955-2243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | SP006364C
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License Number State | PA
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