Provider Demographics
NPI:1114012192
Name:SALTZMAN, SUSANNE MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSANNE
Middle Name:MICHELLE
Last Name:SALTZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HILLARY CT
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10977-6148
Mailing Address - Country:US
Mailing Address - Phone:845-356-7771
Mailing Address - Fax:
Practice Address - Street 1:250 E HARTSDALE AVE
Practice Address - Street 2:ST. 22
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-3571
Practice Address - Country:US
Practice Address - Phone:914-472-0666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186500208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY18H811Medicare UPIN