Provider Demographics
NPI:1366944688
Name:KEITH A SILLER MD PC
Entity type:Organization
Organization Name:KEITH A SILLER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:SILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-413-3148
Mailing Address - Street 1:1615 NORTHERN BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3033
Mailing Address - Country:US
Mailing Address - Phone:516-415-0514
Mailing Address - Fax:516-277-2277
Practice Address - Street 1:1615 NORTHERN BLVD STE 105
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3033
Practice Address - Country:US
Practice Address - Phone:516-415-0514
Practice Address - Fax:516-277-2277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-02
Last Update Date:2025-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty