Provider Demographics
NPI:1992986830
Name:SILVERSTEIN, MEREDITH B (PA)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:B
Last Name:SILVERSTEIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:B
Other - Last Name:ROSENTHAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:609 JEFFERSON ST
Mailing Address - Street 2:APT. 2A
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-2092
Mailing Address - Country:US
Mailing Address - Phone:973-365-4566
Mailing Address - Fax:973-365-4651
Practice Address - Street 1:609 JEFFERSON ST
Practice Address - Street 2:APT. 2A
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-2092
Practice Address - Country:US
Practice Address - Phone:973-365-4566
Practice Address - Fax:973-365-4651
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00190600363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ121268TLMMedicare PIN