Basic Information
| Provider Information | |||||||||
| NPI: | 1659696300 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SILVERMAN | ||||||||
| FirstName: | JESSICA | ||||||||
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| Credential: | RPA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 114 UNIVERSITY AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146052929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5855462771 | ||||||||
| FaxNumber: | 5854547001 | ||||||||
| Practice Location | |||||||||
| Address1: | 2697 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142141701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168312200 | ||||||||
| FaxNumber: | 7168318836 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2010 | ||||||||
| LastUpdateDate: | 08/19/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 013963-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.