Provider Demographics
NPI:1689640294
Name:SALAZAR, JAMES (DPM)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604-1519
Mailing Address - Country:US
Mailing Address - Phone:201-288-5888
Mailing Address - Fax:
Practice Address - Street 1:440 BOULEVARD
Practice Address - Street 2:
Practice Address - City:HASBROUCK HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07604-1500
Practice Address - Country:US
Practice Address - Phone:201-288-5888
Practice Address - Fax:201-288-2359
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005484213ES0131X
NJMD02435213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU68925Medicare UPIN
NJU68925Medicare UPIN
NYPA7501Medicare ID - Type Unspecified
NJ005545Medicare ID - Type Unspecified