Provider Demographics
NPI:1922280544
Name:MADISON ENT & FACIAL PLASTIC SURGERY
Entity Type:Organization
Organization Name:MADISON ENT & FACIAL PLASTIC SURGERY
Other - Org Name:STACEY L SILVERS MD PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SILVERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-213-3339
Mailing Address - Street 1:161 MADISON AVENUE
Mailing Address - Street 2:SUITE 11W
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-213-3339
Mailing Address - Fax:212-213-3494
Practice Address - Street 1:161 MADISON AVENUE
Practice Address - Street 2:SUITE 11W
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-213-3339
Practice Address - Fax:212-213-3494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G44473Medicare UPIN