Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 014864-1 | NY |
Y | 103TC0700X | Clinical Psychologist | 014864-1 | NY |
NPI | 1003933292 |
---|---|
Provider Name | Marian Gail Silverman |
First Address | Commack, NY 11725-3327 |
Second Address | Bronx, NY 10461-1807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 08/07/2007 |