Provider Demographics
NPI:1295978252
Name:SILVERSTEIN, DAVID (MD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:SILVERSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SUFFOLK DERMATOLOGY - 500 PORTION RD STE 11
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779
Mailing Address - Country:US
Mailing Address - Phone:631-648-0101
Mailing Address - Fax:631-648-0191
Practice Address - Street 1:SUFFOLK DERMATOLOGY - 500 PORTION RD STE 11
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779
Practice Address - Country:US
Practice Address - Phone:631-648-0101
Practice Address - Fax:631-648-0191
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY265750-1207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03588869Medicaid