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General NPI Number Information
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NPI Number | 1780798306
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Entity Type | Organization
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Legal Business Name | SILVER CARE MEDICAL PC
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 125 ALEX CIR
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City | STATEN ISLAND
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State | NY
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Zip | 10305-4765
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Country | US
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Telephone | 917-744-0378
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Fax |
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Provider Business Mailing Address
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Address Line | 125 ALEX CIR
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City | STATEN ISLAND
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State | NY
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Zip | 10305-4765
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Country | US
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Telephone | 917-744-0378
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LILIYA GEKHMAN
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Credential | D.O.
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Telephone | 917-744-0378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 223830
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License Number State | NY
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