Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 031705 | NY |
N | 2251S0007X | Physical Therapist - Sports | 031705 | NY |
N | 2251X0800X | Physical Therapist - Orthopedic | 031705 | NY |
NPI | 1053542191 |
---|---|
Provider Name | Gavin Matthew Silver |
First Address | New York, NY 10075-1851 |
Second Address | New York, NY 10021-3249 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2009 |
Last Update Date | 06/08/2009 |