1801998687 NPI number — JACQUELINE G SALZMAN MD

Table of content: JACQUELINE G SALZMAN MD (NPI 1801998687)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801998687 NPI number — JACQUELINE G SALZMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALZMAN
Provider First Name:
JACQUELINE
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801998687
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 SOUTH BROADWAY
Provider Second Line Business Mailing Address:
SUITE 211
Provider Business Mailing Address City Name:
TARRYTOWN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10591
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-332-5394
Provider Business Mailing Address Fax Number:
914-332-5465

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 SOUTH BROADWAY
Provider Second Line Business Practice Location Address:
SUITE 211
Provider Business Practice Location Address City Name:
TARRYTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10591
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-332-5394
Provider Business Practice Location Address Fax Number:
914-332-5465
Provider Enumeration Date:
09/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  147079 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: WS1064 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".