Provider Demographics
NPI:1568851715
Name:MARK R SILK, M.D., P.C.
Entity Type:Organization
Organization Name:MARK R SILK, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:UROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:SILK
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:860-522-7134
Mailing Address - Street 1:1000 ASYLUM AVE
Mailing Address - Street 2:SUITE 2101
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1770
Mailing Address - Country:US
Mailing Address - Phone:860-522-7134
Mailing Address - Fax:860-522-7135
Practice Address - Street 1:1000 ASYLUM AVE
Practice Address - Street 2:SUITE 2101
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1770
Practice Address - Country:US
Practice Address - Phone:860-522-7134
Practice Address - Fax:860-522-7135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT05297Medicare PIN
CT340000082Medicare UPIN