Provider Demographics
NPI:1932463643
Name:SILVERMAN, TYLER (DPM)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 HEWS ST
Mailing Address - Street 2:APT 3
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-2908
Mailing Address - Country:US
Mailing Address - Phone:203-733-7515
Mailing Address - Fax:
Practice Address - Street 1:1492 CAMBRIDGE ST
Practice Address - Street 2:CAMBRIDGE HEALTH ALLIANCE
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1004
Practice Address - Country:US
Practice Address - Phone:617-665-3570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1289390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program