Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 009241 | NY |
Y | 103TC0700X | Clinical Psychologist | 009241 | NY |
NPI | 1003314253 |
---|---|
Provider Name | Dr. Jeremy Silverman |
First Address | Bronx, NY 10468-3904 |
Second Address | Bronx, NY 10468-3904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2018 |
Last Update Date | 23/01/2018 |