Basic Information
| Provider Information | |||||||||
| NPI: | 1861433468 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SILVERMAN | ||||||||
| FirstName: | MARVIN | ||||||||
| MiddleName: | JAY | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 307 S EVERGREEN AVE | ||||||||
| Address2: | |||||||||
| City: | WOODBURY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080962739 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566864300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1202 LANGHORNE NEWTOWN RD | ||||||||
| Address2: | |||||||||
| City: | LANGHORNE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190471234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157102100 | ||||||||
| FaxNumber: | 2157105861 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2006 | ||||||||
| LastUpdateDate: | 07/17/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | OS002728L | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.