Provider Demographics
NPI:1891713129
Name:SILVERMAN, MARC M (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:M
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 WESTCHESTER AVE
Mailing Address - Street 2:SUITE: LL3
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461
Mailing Address - Country:US
Mailing Address - Phone:718-409-0673
Mailing Address - Fax:718-409-3486
Practice Address - Street 1:3250 WESTCHESTER AVE
Practice Address - Street 2:SUITE LL3
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-409-0073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167766207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01272682Medicaid
NY77F641Medicare ID - Type Unspecified
NYE74472Medicare UPIN