Provider Demographics
NPI:1225162647
Name:SILVERMAN, TRACY (MSPT)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:SILVERMAN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 BRUCE HILL RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04021-3300
Mailing Address - Country:US
Mailing Address - Phone:207-712-2562
Mailing Address - Fax:
Practice Address - Street 1:179 BRUCE HILL RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:ME
Practice Address - Zip Code:04021-3300
Practice Address - Country:US
Practice Address - Phone:207-712-2562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT2713225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEAA34202OtherHARVARD PILGRIM
ME3981767OtherAETNA
ME022802OtherANTHEM BCBS
ME8902972OtherCIGNA