Provider Demographics
NPI:1831283464
Name:SILVERMAN, MARK (PHD)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:SILVERMAN
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 1:100 TRAVER ROAD
Mailing Address - Street 2:
Mailing Address - City:WILLSEYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13864-1124
Mailing Address - Country:US
Mailing Address - Phone:607-277-3345
Mailing Address - Fax:
Practice Address - Street 1:157 GENESEE STREET
Practice Address - Street 2:BASEMENT
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3461
Practice Address - Country:US
Practice Address - Phone:315-253-0341
Practice Address - Fax:315-253-1129
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist