Provider Demographics
NPI:1013099159
Name:SILVER, MARISA RACHEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MARISA
Middle Name:RACHEL
Last Name:SILVER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 JERICHO TPKE
Mailing Address - Street 2:SUITE 120W
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4436
Mailing Address - Country:US
Mailing Address - Phone:516-393-5862
Mailing Address - Fax:
Practice Address - Street 1:6800 JERICHO TPKE
Practice Address - Street 2:SUITE 120W
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4436
Practice Address - Country:US
Practice Address - Phone:516-393-5862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010199111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX5P91AW711Medicare PIN