Provider Demographics
NPI:1942248075
Name:SILVESTI, GARRY M (PA-C, DC)
Entity Type:Individual
Prefix:DR
First Name:GARRY
Middle Name:M
Last Name:SILVESTI
Suffix:
Gender:M
Credentials:PA-C, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 MORRIS AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5675
Mailing Address - Country:US
Mailing Address - Phone:732-906-9600
Mailing Address - Fax:
Practice Address - Street 1:1801 NEW RD
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1036
Practice Address - Country:US
Practice Address - Phone:609-208-8969
Practice Address - Fax:833-606-0167
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00368800363A00000X, 363A00000X
NJMC04579111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0011461Medicaid
NJ58257Medicare UPIN
NJ672928Medicare ID - Type Unspecified