Provider Demographics
NPI:1598041766
Name:SALANGER, MELANIE F (PA)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:F
Last Name:SALANGER
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 1:5112 W TAFT RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-4868
Mailing Address - Country:US
Mailing Address - Phone:315-452-3235
Mailing Address - Fax:315-410-7490
Practice Address - Street 1:5112 W TAFT RD
Practice Address - Street 2:SUITE H
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-4868
Practice Address - Country:US
Practice Address - Phone:315-452-3235
Practice Address - Fax:315-410-7490
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY958956282363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400065579Medicare PIN