Provider Demographics
NPI:1417155458
Name:SILVESTRI, RICHARD J (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:SILVESTRI
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 1:546 HIGH MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-2606
Mailing Address - Country:US
Mailing Address - Phone:973-427-0397
Mailing Address - Fax:973-423-9580
Practice Address - Street 1:546 HIGH MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:NORTH HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-2606
Practice Address - Country:US
Practice Address - Phone:973-427-0397
Practice Address - Fax:973-423-9580
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00106900103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA612568Medicare PIN