Provider Demographics
NPI:1245486380
Name:SILVERBERG, GARY ALLEN (DC)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:ALLEN
Last Name:SILVERBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 PLEASANT LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-3446
Mailing Address - Country:US
Mailing Address - Phone:516-946-1412
Mailing Address - Fax:
Practice Address - Street 1:38 PLEASANT LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-3446
Practice Address - Country:US
Practice Address - Phone:516-946-1412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYC03018111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX21042Medicare PIN