Provider Demographics
NPI:1730496936
Name:SILBER, MARTIN MERRILL (LAC)
Entity Type:Individual
Prefix:PROF
First Name:MARTIN
Middle Name:MERRILL
Last Name:SILBER
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 NORTHAMPTON GATE
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-1010
Mailing Address - Country:US
Mailing Address - Phone:516-932-6702
Mailing Address - Fax:
Practice Address - Street 1:2 NORTHAMPTON GATE
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-1010
Practice Address - Country:US
Practice Address - Phone:516-342-1644
Practice Address - Fax:516-342-1644
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001141225200000X
NY005372225700000X
NY000615171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist