Basic Information
| Provider Information | |||||||||
| NPI: | 1518929488 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SILVERMAN | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 314 S MANNING BLVD | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122081708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184375717 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 314 S MANNING BLVD | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122081708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184375717 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 150639 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 00150639 | 05 | NY | MEDICAID | 000405918006 | 01 | BSNENY | OTHER | 57032 | 01 | GHIHMO | OTHER | 3099511 | 01 | GHI | OTHER | 401N61 | 01 | EMPIRE BLUE CROSS | OTHER | 10001897 | 01 | CDPHP | OTHER | 040426005957 | 01 | FIDELIS | OTHER | 13010 | 01 | MVP | OTHER |