Provider Demographics
NPI:1124008701
Name:SILVER, LARRY M (DPM)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:M
Last Name:SILVER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3207 FRANCIS LEWIS BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1922
Mailing Address - Country:US
Mailing Address - Phone:718-224-2030
Mailing Address - Fax:718-281-2617
Practice Address - Street 1:3207 FRANCIS LEWIS BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1922
Practice Address - Country:US
Practice Address - Phone:718-224-2030
Practice Address - Fax:718-281-2617
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004911213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01808442Medicaid
NY01808442Medicaid
NYU25742Medicare UPIN