Silver Lake Medical PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

164175 Issued in NY

Legal business name

SILVER LAKE MEDICAL PLLC

Practice address

59 Revere St
Suite a
Staten Island, NY 10301-3415

Phone

(718) 556-3900

Fax

(718) 273-3592

NPI assigned

Jul 26, 2007

Last updated

Jul 27, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenneth Pickover, M.D.NPI 1528055076

Title

Member

Phone

(718) 556-3900

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Howard Pickover, M.D.

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1528055076
  Authorized official Same address or phone
• Claire Bornstein, P.A.-C.

  • Medical Physician Assistant
  • Staten Island, NY
  • NPI 1285766766
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1760672620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 REVERE ST",
            "address_2": "SUITE A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013415",
            "telephone_number": "718-556-3900",
            "fax_number": "718-273-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 REVERE ST",
            "address_2": "SUITE A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013415",
            "telephone_number": "718-556-3900",
            "fax_number": "718-273-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER LAKE MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "PICKOVER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-556-3900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "164175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Marie Silva, MD
• Sydney Grace Silva
• Jamie Lynn Silveira, MSSPED
• Silver Care Medical PC
• Silver Lake Counseling Services, LLC
• Silver Lake Psychotherapy Associates, PLLC
• Silver Lake Specialized Rehabilitation & Care Center, LLC (Silver Lake Specialized Care Center)
• Silver Lake Support Services
• Silver Lake Support Services, Inc
• Howard Silverman, D.D.S.

• Internal Medicine Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.