Provider Demographics
NPI:1659594778
Name:SILVERBERG, FARRELL R (PHD)
Entity Type:Individual
Prefix:DR
First Name:FARRELL
Middle Name:R
Last Name:SILVERBERG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5614
Mailing Address - Country:US
Mailing Address - Phone:215-545-1096
Mailing Address - Fax:
Practice Address - Street 1:2024 LOCUST ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-5614
Practice Address - Country:US
Practice Address - Phone:215-545-1096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000800102L00000X
NY01025103TP0814X
PA4478L103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst