Provider Demographics
NPI:1184007577
Name:SILVERMAN, STEPHEN (MED)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 BELL BLVD
Mailing Address - Street 2:APT. 512
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1645
Mailing Address - Country:US
Mailing Address - Phone:718-541-1182
Mailing Address - Fax:718-352-4205
Practice Address - Street 1:7000 AUSTIN ST. SUITE 200
Practice Address - Street 2:ACHIEVE BEYOND
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:718-762-7633
Practice Address - Fax:718-886-8694
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005256821252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency