MEDICARE: MARIAN GAIL SILVERMAN PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	014864-1	NY

General Provider Information

NPI Number	:	1003933292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAN GAIL SILVERMAN PSY.D.

Provider Business Mailing Address
First Line	:	47 LARRY DR
Second Line	:
City	:	COMMACK
State	:	NY
Zip	:	11725-3327
Country	:	US
Telephone Number	:	631-858-1744
Fax Number	:

Provider Business Practice Location Address
First Line	:	1731 SEMINOLE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1807
Country	:	US
Telephone Number	:	718-430-8900
Fax Number	:	718-892-4736

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	07/08/2007

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