Provider Demographics
NPI:1063050052
Name:SILBERBERG, PAUL JOSHUA
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:JOSHUA
Last Name:SILBERBERG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 FRIAR TUCK WAY
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-6165
Mailing Address - Country:US
Mailing Address - Phone:401-773-3784
Mailing Address - Fax:
Practice Address - Street 1:37 FRIAR TUCK WAY
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-6165
Practice Address - Country:US
Practice Address - Phone:401-773-3784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-20
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW03149104100000X
NY18210789321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker