Provider Demographics
NPI:1992119515
Name:SILVERBERG, SHELLI
Entity type:Individual
Prefix:
First Name:SHELLI
Middle Name:
Last Name:SILVERBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 KENMAR DR UNIT 7
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-4735
Mailing Address - Country:US
Mailing Address - Phone:978-998-9613
Mailing Address - Fax:
Practice Address - Street 1:3 KENMAR DR UNIT 7
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-4735
Practice Address - Country:US
Practice Address - Phone:978-998-9613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2263737163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent