Provider Demographics
NPI:1417196874
Name:GENE, SALMA (PA)
Entity Type:Individual
Prefix:MRS
First Name:SALMA
Middle Name:
Last Name:GENE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E MERRICK RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5800
Mailing Address - Country:US
Mailing Address - Phone:516-256-2017
Mailing Address - Fax:
Practice Address - Street 1:10 E MERRICK RD
Practice Address - Street 2:SUITE 207
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5800
Practice Address - Country:US
Practice Address - Phone:516-256-2017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012847363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical