Provider Demographics
NPI:1275886541
Name:MAKIL, SALBY SIMON
Entity Type:Individual
Prefix:
First Name:SALBY
Middle Name:SIMON
Last Name:MAKIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:SALBY
Other - Middle Name:MAKIL
Other - Last Name:SIMON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:96 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2310
Mailing Address - Country:US
Mailing Address - Phone:917-375-2237
Mailing Address - Fax:212-656-1091
Practice Address - Street 1:346 BEEBE RD
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-1112
Practice Address - Country:US
Practice Address - Phone:718-470-1266
Practice Address - Fax:516-279-4174
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022383225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist