Provider Demographics
NPI:1679507040
Name:SALMAN, NADA M (MD)
Entity Type:Individual
Prefix:
First Name:NADA
Middle Name:M
Last Name:SALMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 KENNEDY PKWY
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-1409
Mailing Address - Country:US
Mailing Address - Phone:607-753-8571
Mailing Address - Fax:607-753-8422
Practice Address - Street 1:5 KENNEDY PKWY
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-1409
Practice Address - Country:US
Practice Address - Phone:607-753-8571
Practice Address - Fax:607-753-8422
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161664207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00904238Medicaid
NY00904238Medicaid
C59327Medicare UPIN