Provider Demographics
NPI:1467781542
Name:TIBERIU SALAMON M.D., P.C.
Entity Type:Organization
Organization Name:TIBERIU SALAMON M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIBERIU
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-737-3586
Mailing Address - Street 1:225 EAST 79 STR
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0855
Mailing Address - Country:US
Mailing Address - Phone:212-737-3586
Mailing Address - Fax:212-744-7886
Practice Address - Street 1:225 EAST 79 STR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0855
Practice Address - Country:US
Practice Address - Phone:212-737-3586
Practice Address - Fax:212-744-7886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-18
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY132437207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00248586Medicaid
NY00248586Medicaid
NYB13096Medicare UPIN