Provider Demographics
NPI:1689673246
Name:SILVER, ANN M (MS, RDN, CDCES, CDN)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:M
Last Name:SILVER
Suffix:
Gender:F
Credentials:MS, RDN, CDCES, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:SAG HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11963-0008
Mailing Address - Country:US
Mailing Address - Phone:631-324-1953
Mailing Address - Fax:631-967-1953
Practice Address - Street 1:200 PANTIGO PL STE I
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11937-5922
Practice Address - Country:US
Practice Address - Phone:631-324-1953
Practice Address - Fax:631-967-1953
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-17
Last Update Date:2020-12-17
Deactivation Date:2006-03-18
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
NY000199133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
1486839OtherUNITED HEALTHCARE
P829215OtherOXFORD HEALTH PLANS
2660704OtherCIGNA
NY9085E1OtherBLUE CROSS BLUE SHIELD
NY7448180OtherAETNA
NY9085E1OtherBLUE CROSS BLUE SHIELD