MEDICARE: DR. JUDITH LYNN SILVERSTEIN PHD

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	4200	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	W04129	OTHER	MA	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1033292834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH LYNN SILVERSTEIN PHD

Provider Business Mailing Address
First Line	:	29 BRIARWOOD CIR
Second Line	:
City	:	NEEDHAM HEIGHTS
State	:	MA
Zip	:	02494-1829
Country	:	US
Telephone Number	:	781-449-6211
Fax Number	:	781-449-4042

Provider Business Practice Location Address
First Line	:	29 BRIARWOOD CIR
Second Line	:
City	:	NEEDHAM HEIGHTS
State	:	MA
Zip	:	02494-1829
Country	:	US
Telephone Number	:	781-449-6211
Fax Number	:	781-449-4042

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	07/08/2007

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