Provider Demographics
NPI:1811040801
Name:SILVESTER, RICHARD S (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:SILVESTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:S
Other - Last Name:SILVESTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:4 HARTFORD LN
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-1113
Mailing Address - Country:US
Mailing Address - Phone:914-592-6032
Mailing Address - Fax:914-592-0449
Practice Address - Street 1:4 HARTFORD LN
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-1113
Practice Address - Country:US
Practice Address - Phone:914-683-6665
Practice Address - Fax:914-592-0449
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04854103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01825929Medicaid
NY01825929Medicaid