SILVER LAKE MEDICAL PC NPI 1538366679

NPI Information

  • NPI: 1538366679
  • Provider Name: SILVER LAKE MEDICAL PC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 36 NEWARK AVENUE
    SUITE 324
    BELLEVILLE, NJ
    ZIP 07109
  • Phone: (973) 751-2060

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NPI Details

SILVER LAKE MEDICAL PC is a family medicine in Belleville, NJ. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SILVER LAKE MEDICAL PC NPI is 1538366679. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

36 NEWARK AVENUE
SUITE 324
BELLEVILLE, NJ
ZIP 07109
Phone: (973) 751-2060
Fax: (973) 751-3334

The provider's authorized official is Antonio Ciccone .
The authorized official title is President and has the following contact phone number (973) 751-2060.

The enumeration date for this NPI number is 7/2/2007 and was last updated on 6/16/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineMB57523NEW JERSEYYes

What is NPI?

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This page was last updated on: 11/21/2025

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