Provider Demographics
NPI:1770714842
Name:SILVERSTEIN, JUSTIN W (DHSC, CNIM)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:W
Last Name:SILVERSTEIN
Suffix:
Gender:M
Credentials:DHSC, CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ADAMS AVE
Mailing Address - Street 2:SUITE B-13
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-3618
Mailing Address - Country:US
Mailing Address - Phone:631-617-6011
Mailing Address - Fax:631-617-6023
Practice Address - Street 1:140 ADAMS AVE
Practice Address - Street 2:SUITE B-13
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-3618
Practice Address - Country:US
Practice Address - Phone:631-617-6011
Practice Address - Fax:631-617-6023
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZE0500X, 2472E0500X
NY1184246ZE0600X
NC11842084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG