Provider Demographics
NPI:1538298757
Name:SILVERSTEIN, STUART C
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:C
Last Name:SILVERSTEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 HIGH RIDGE RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-1610
Mailing Address - Country:US
Mailing Address - Phone:203-968-1900
Mailing Address - Fax:203-968-0151
Practice Address - Street 1:1011 HIGH RIDGE RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-1610
Practice Address - Country:US
Practice Address - Phone:203-968-1900
Practice Address - Fax:203-968-0151
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223190207PP0204X
CT034756208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02256242Medicaid
NY862V61Medicare ID - Type UnspecifiedMEDICARE
NY02256242Medicaid