Provider Demographics
NPI:1285628297
Name:SALANSKY, PAUL LLOYD JR (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:LLOYD
Last Name:SALANSKY
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:NEBRASKA CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68410
Mailing Address - Country:US
Mailing Address - Phone:402-873-6696
Mailing Address - Fax:402-873-5149
Practice Address - Street 1:121 N 8TH ST
Practice Address - Street 2:
Practice Address - City:NEBRASKA CITY
Practice Address - State:NE
Practice Address - Zip Code:68410
Practice Address - Country:US
Practice Address - Phone:402-873-6696
Practice Address - Fax:402-873-5149
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE833152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE06737OtherBCBS
NE410029442OtherRAILROAD MEDICARE
NE47072188700Medicaid
NE2200002OtherUNITED HEALTHCARE
NE2200004OtherMEDICARE COMPLETE
NE13691OtherMIDLANDS CHOICE
NE410022770OtherRAILROAD MEDICARE
NE47072188701Medicaid
NE0448340001OtherCIGNA (DMERC)
NE0448340002OtherCIGNA (DMERC)
NE0448340001OtherCIGNA (DMERC)
NE410022770OtherRAILROAD MEDICARE
NE06737OtherBCBS
NE0448340002OtherCIGNA (DMERC)
NE097240Medicare ID - Type Unspecified