Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 148486-1 | NY |
NPI | 1043278088 |
---|---|
Provider Name | Dr. Stacey Silver-Weber |
First Address | Bay Shore, NY 11706-8408 |
Second Address | Bay Shore, NY 11706-8408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 29/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00836842 | (05) | NY |
C06797 | (02) |