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Organization
SILVER LAKE MEDICAL PLLC
Active
Organization
SILVER LAKE MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH PICKOVER M.D. (MEMBER)
(718) 556-3900
Entity
Organization
Contact information
Practice address
59 REVERE ST, SUITE A, STATEN ISLAND, NY 10301-3415
(718) 556-3900
(718) 273-3592
Mailing address
59 REVERE ST, SUITE A, STATEN ISLAND, NY 10301-3415
(718) 556-3900
(718) 273-3592
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
164175
NY
Other
Enumeration date
07/26/2007
Last updated
07/27/2007
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