Provider Demographics
NPI:1225052699
Name:SILVERSTEIN, MARSHALL L (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:L
Last Name:SILVERSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 SALISBURY PARK DR
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-5820
Mailing Address - Country:US
Mailing Address - Phone:516-338-2810
Mailing Address - Fax:516-338-2810
Practice Address - Street 1:710 SALISBURY PARK DR
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-5820
Practice Address - Country:US
Practice Address - Phone:516-338-2810
Practice Address - Fax:516-338-2810
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010819-2103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV73131Medicare ID - Type Unspecified