Provider Demographics
NPI:1053377796
Name:SILVER, RUSSELL HOWARD (MD)
Entity type:Individual
Prefix:
First Name:RUSSELL
Middle Name:HOWARD
Last Name:SILVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 E 74TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3235
Mailing Address - Country:US
Mailing Address - Phone:212-439-9302
Mailing Address - Fax:
Practice Address - Street 1:159 EAST 74TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-439-9302
Practice Address - Fax:212-988-4244
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1696941208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM607393300Medicaid
NM607393300Medicaid
NY30F711Medicare ID - Type Unspecified