Provider Demographics
NPI:1891969408
Name:SILBERT, LARRY (OD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:
Last Name:SILBERT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1107
Mailing Address - Country:US
Mailing Address - Phone:781-487-7373
Mailing Address - Fax:781-487-7373
Practice Address - Street 1:71 2ND AVE
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1107
Practice Address - Country:US
Practice Address - Phone:781-487-7373
Practice Address - Fax:781-487-7373
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2741152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist