Provider Demographics
NPI:1104050129
Name:SILVERMAN, SUSANNA (MD)
Entity type:Individual
Prefix:
First Name:SUSANNA
Middle Name:
Last Name:SILVERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 PARK AVE S
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8806
Mailing Address - Country:US
Mailing Address - Phone:212-260-6078
Mailing Address - Fax:212-260-6185
Practice Address - Street 1:381 PARK AVE S
Practice Address - Street 2:SUITE 1020
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8806
Practice Address - Country:US
Practice Address - Phone:212-260-6078
Practice Address - Fax:212-260-6185
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264092207RA0201X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine