Provider Demographics
NPI:1538196001
Name:SILVERSTEIN, KURT (DO)
Entity type:Individual
Prefix:DR
First Name:KURT
Middle Name:
Last Name:SILVERSTEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 WHEELER RD
Mailing Address - Street 2:SUITE 265
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2964
Mailing Address - Country:US
Mailing Address - Phone:631-361-2254
Mailing Address - Fax:631-361-2279
Practice Address - Street 1:900 WHEELER ROAD
Practice Address - Street 2:SUITE 265
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788
Practice Address - Country:US
Practice Address - Phone:631-361-2254
Practice Address - Fax:631-361-2279
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197289207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01673532Medicaid
G32209Medicare UPIN
NY651311Medicare PIN