Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 110780 | NY |
NPI | 1134213036 |
---|---|
Provider Name | Dr. Michael Silane |
First Address | New York, NY 10128-1212 |
Second Address | New York, NY 10128-1212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00636195 | (05) | NY |
295351 | BLUE CROSS BLUE SHIELD (01) | NY |
B12446 | (02) | NY |
P393182 | OXFORD (01) | NY |