Provider Demographics
NPI:1134137383
Name:MASLAVI, SAUL F (MD)
Entity Type:Individual
Prefix:
First Name:SAUL
Middle Name:F
Last Name:MASLAVI
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4232 FRANCIS LEWIS BLVD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2561
Mailing Address - Country:US
Mailing Address - Phone:718-717-0003
Mailing Address - Fax:718-225-6936
Practice Address - Street 1:42-32 FRANCIS LEWIS BLVD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3211
Practice Address - Country:US
Practice Address - Phone:718-717-0003
Practice Address - Fax:718-225-6936
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2016-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY228782207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02551875Medicaid
NY02551875Medicaid
NY5195DEN441Medicare PIN