Provider Demographics
NPI:1750499810
Name:SALITAN, MICHAEL LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LAWRENCE
Last Name:SALITAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:589 BROADWAY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3231
Mailing Address - Country:US
Mailing Address - Phone:212-219-7600
Mailing Address - Fax:212-219-8812
Practice Address - Street 1:589 BROADWAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3231
Practice Address - Country:US
Practice Address - Phone:212-219-7600
Practice Address - Fax:212-219-8812
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY166311207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE44658Medicare UPIN
NY31F391Medicare ID - Type Unspecified