Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Silver Lake Medical PLLC

Organization Internal Medicine Physician · NPI 1760672620

Silver Lake Medical PLLC is an Internal Medicine Physician in Staten Island, New York. Licensed in New York. Registered with an NPI since 2007.

Licensed in
NY
In the registry since
2007
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

59 Revere St Ste A
Staten Island, NY 10301-3415
Phone: (718) 556-3900
Fax: (718) 273-3592
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 164175 (NY)

Record details

NPI number1760672620
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kenneth Pickover — Member · (718) 556-3900
NPI enumeratedJuly 26, 2007
Last updated in NPPESJuly 27, 2007
Mailing address59 Revere St, Suite A, Staten Island, NY 10301-3415

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