Provider Demographics
NPI:1396827747
Name:MIR, SALEEM M (MD)
Entity Type:Individual
Prefix:DR
First Name:SALEEM
Middle Name:M
Last Name:MIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:132 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520
Mailing Address - Country:US
Mailing Address - Phone:914-271-6606
Mailing Address - Fax:914-271-7754
Practice Address - Street 1:132 MAPLE ST
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520
Practice Address - Country:US
Practice Address - Phone:914-271-6606
Practice Address - Fax:914-271-7754
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY115277207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00519517Medicaid
B77875Medicare UPIN
570771Medicare ID - Type Unspecified