Provider Demographics
NPI:1487666251
Name:SALGADO, DANA S (OD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:S
Last Name:SALGADO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MRS
Other - First Name:DANA
Other - Middle Name:SHALINI
Other - Last Name:LEVESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1692 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-4045
Mailing Address - Country:US
Mailing Address - Phone:518-869-2560
Mailing Address - Fax:518-869-2580
Practice Address - Street 1:1692 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-4045
Practice Address - Country:US
Practice Address - Phone:518-869-2560
Practice Address - Fax:518-869-2580
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007008152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02792703Medicaid
J400024502Medicare PIN
NYRB1695Medicare PIN
NY02792703Medicaid
NYRB1697Medicare PIN
NYRB1698Medicare PIN