Provider Demographics
NPI:1083620355
Name:SILVERMAN, BRETT (DO)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-1601
Mailing Address - Country:US
Mailing Address - Phone:631-364-9119
Mailing Address - Fax:631-364-9118
Practice Address - Street 1:1512 BROADWAY
Practice Address - Street 2:ISLAND MUSCULOSKELETAL CARE MD PC
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-9998
Practice Address - Country:US
Practice Address - Phone:516-374-6838
Practice Address - Fax:516-374-6838
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219724208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400139113OtherMEDICARE PTAN
NY02499085Medicaid
H87411Medicare UPIN
NY02499085Medicaid