Provider Demographics
NPI:1710075767
Name:SILVERSTEIN OPHTHALMOLOGY GROUP LLC
Entity Type:Organization
Organization Name:SILVERSTEIN OPHTHALMOLOGY GROUP LLC
Other - Org Name:WEST JERSEY EYE MDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIKI
Authorized Official - Middle Name:A
Authorized Official - Last Name:SILVERSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-473-1515
Mailing Address - Street 1:777 PASSAIC AVE
Mailing Address - Street 2:SUITE 485
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1804
Mailing Address - Country:US
Mailing Address - Phone:973-473-1515
Mailing Address - Fax:973-473-4811
Practice Address - Street 1:777 PASSAIC AVE
Practice Address - Street 2:SUITE 485
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1804
Practice Address - Country:US
Practice Address - Phone:973-473-1515
Practice Address - Fax:973-473-4811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3267105Medicaid
NJD47476Medicare UPIN
NJ3267105Medicaid
NJD07221Medicare UPIN
NJ0607190002Medicare NSC
NJ0607190001Medicare NSC