Provider Demographics
NPI:1043235161
Name:SALOMON, GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:
Last Name:SALOMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 LIBERTY SQUARE MALL
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980
Mailing Address - Country:US
Mailing Address - Phone:845-947-8828
Mailing Address - Fax:845-269-3455
Practice Address - Street 1:27 LIBERTY SQUARE MALL
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980
Practice Address - Country:US
Practice Address - Phone:845-947-8828
Practice Address - Fax:845-269-3455
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1987282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG17974Medicaid