Provider Demographics
NPI:1629094156
Name:SILVER CKD, INC
Entity Type:Organization
Organization Name:SILVER CKD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-795-3131
Mailing Address - Street 1:1417 BRACE RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3524
Mailing Address - Country:US
Mailing Address - Phone:856-795-3131
Mailing Address - Fax:856-795-7062
Practice Address - Street 1:1417 BRACE RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3524
Practice Address - Country:US
Practice Address - Phone:856-795-3131
Practice Address - Fax:856-795-7062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22241261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0075892Medicaid
NJ067121Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER