Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | MA070162 | NJ |
NPI | 1215964846 |
---|---|
Provider Name | Dr. Marc Richard Silberman |
First Address | Bedminster, NJ 07921-2109 |
Second Address | Gillette, NJ 07933-1919 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I17104 | (02) | NJ |