Provider Demographics
NPI:1558588095
Name:SILVESTRI, HEATHER L (PHD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:L
Last Name:SILVESTRI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 SAINT MARKS PL
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-5117
Mailing Address - Country:US
Mailing Address - Phone:212-614-9600
Mailing Address - Fax:212-614-9600
Practice Address - Street 1:103 SAINT MARKS PL
Practice Address - Street 2:SUITE A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-5117
Practice Address - Country:US
Practice Address - Phone:212-614-9600
Practice Address - Fax:212-614-9600
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015635-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical