Provider Demographics
NPI:1164638706
Name:SALANT, MARILYN MOFFAT (PT, DPT, PHD)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:MOFFAT
Last Name:SALANT
Suffix:
Gender:F
Credentials:PT, DPT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 LUDLAM LN
Mailing Address - Street 2:
Mailing Address - City:LOCUST VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11560-1724
Mailing Address - Country:US
Mailing Address - Phone:516-671-1002
Mailing Address - Fax:516-671-7987
Practice Address - Street 1:29 LUDLAM LN
Practice Address - Street 2:
Practice Address - City:LOCUST VALLEY
Practice Address - State:NY
Practice Address - Zip Code:11560-1724
Practice Address - Country:US
Practice Address - Phone:516-671-1002
Practice Address - Fax:516-671-7987
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2006225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist