Provider Demographics
NPI:1083786347
Name:SELBY SILVERSTEIN, LISA (PT, PHD, NCS)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:SELBY SILVERSTEIN
Suffix:
Gender:F
Credentials:PT, PHD, NCS
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:SELBY-SILVERSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, PHD, NCS
Mailing Address - Street 1:12 FRIAR TUCK DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8542
Mailing Address - Country:US
Mailing Address - Phone:609-714-1236
Mailing Address - Fax:609-261-8632
Practice Address - Street 1:300 CAMPUS DR STE A
Practice Address - Street 2:RR# 30
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-9604
Practice Address - Country:US
Practice Address - Phone:609-261-3434
Practice Address - Fax:609-261-8632
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist