Provider Demographics
NPI:1437557675
Name:SILVERMAN, STEPHANIE DENARDIS (LAC, LMT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DENARDIS
Last Name:SILVERMAN
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CARMAN LN
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-1306
Mailing Address - Country:US
Mailing Address - Phone:917-399-5430
Mailing Address - Fax:
Practice Address - Street 1:16 CARMAN LN
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-1306
Practice Address - Country:US
Practice Address - Phone:917-399-5430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-19
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022763-1225700000X
NY005460171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty