Provider Demographics
NPI:1083713853
Name:SICHERMAN, HERVEY SILAS (MD)
Entity Type:Individual
Prefix:DR
First Name:HERVEY
Middle Name:SILAS
Last Name:SICHERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 HAMBURG TPKE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470
Mailing Address - Country:US
Mailing Address - Phone:973-839-5700
Mailing Address - Fax:973-616-4343
Practice Address - Street 1:1777 HAMBURG TPKE
Practice Address - Street 2:SUITE 301
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470
Practice Address - Country:US
Practice Address - Phone:973-839-5700
Practice Address - Fax:973-616-4343
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02593900207X00000X
NJMA025939207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1074689OtherHORIZON
NJ9661480OtherGHI
NJ4159OtherLOCAL 825
223338995OtherTAX ID
NJPS166OtherOXFORD
NJ0504225OtherAETNA
NJ110340OtherBEECHSTREET
NJ578951OtherEMPIRE
NJ71602001OtherONE HEALTH PLAN
NJ746693OtherFIRST HEALTH
NJ10316586OtherMAGNACARE
NJ1074689OtherANTHEM
NJ20019245OtherRAILROAD MEDICARE
NJ22011051OtherECS
NJ4159OtherOPERATING LOCAK
NJ077148403OtherCIGNA
NJ0K0489OtherHEALTHNET
NJ967203Medicaid
NJC61026Medicare UPIN
NJ051057Medicare ID - Type UnspecifiedMD