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General NPI Number Information
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NPI Number | 1639541774
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Entity Type | Individual
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Provider Name | ERIC EDWARD SILK PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 18114 N GOLDENRIDGE WAY
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City | BOISE
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State | ID
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Zip | 83714-8885
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Country | US
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Telephone | 646-431-8084
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Fax |
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Provider Business Mailing Address
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Address Line | 18114 N GOLDENRIDGE WAY
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City | BOISE
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State | ID
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Zip | 83714-8885
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Country | US
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Telephone | 646-431-8084
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 526
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 526
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License Number State | WY
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