Provider Demographics
NPI:1689879066
Name:SALTZMAN, ROBIN DALE (LAC LMTH)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:DALE
Last Name:SALTZMAN
Suffix:
Gender:F
Credentials:LAC LMTH
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:DALE
Other - Last Name:SUSSMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 531
Mailing Address - Street 2:
Mailing Address - City:STONE RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12484
Mailing Address - Country:US
Mailing Address - Phone:845-687-7999
Mailing Address - Fax:845-687-0089
Practice Address - Street 1:3631 MAIN ST
Practice Address - Street 2:
Practice Address - City:STONE RIDGE
Practice Address - State:NY
Practice Address - Zip Code:12484
Practice Address - Country:US
Practice Address - Phone:845-687-7999
Practice Address - Fax:845-687-0089
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002803171100000X
NY003254225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist