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General NPI Number Information
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NPI Number | 1760494538
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Entity Type | Individual
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Provider Name | SILBURN WILSON THOMAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 105 STEVENS AVE SUITE 602
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City | MOUNT VERNON
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State | NY
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Zip | 10550-2686
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Country | US
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Telephone | 914-668-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 288 S HIGHLAND AVE
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City | BRIARCLIFF MANOR
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State | NY
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Zip | 10510-2038
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Country | US
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Telephone | 914-762-8208
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 176335
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License Number State | NY
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