Provider Demographics
NPI:1780928051
Name:ADOLPH SILBERMAN, ED.D.P.C.
Entity type:Organization
Organization Name:ADOLPH SILBERMAN, ED.D.P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADOLPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SILBERMAN ED.D.P.C.
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:480-839-6264
Mailing Address - Street 1:2600 E SOUTHERN AVE
Mailing Address - Street 2:SUITE C-3
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7610
Mailing Address - Country:US
Mailing Address - Phone:480-839-6264
Mailing Address - Fax:
Practice Address - Street 1:2600 E SOUTHERN AVE
Practice Address - Street 2:SUITE C-3
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7610
Practice Address - Country:US
Practice Address - Phone:480-839-6264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-26
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ167103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZEDD167Medicare PIN