Provider Demographics
NPI:1750653903
Name:JACQUELINE G. SALZMAN, M.D. P.C.
Entity Type:Organization
Organization Name:JACQUELINE G. SALZMAN, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:G
Authorized Official - Last Name:SALZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-332-5394
Mailing Address - Street 1:200 S BROADWAY
Mailing Address - Street 2:SUITE 211
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-4500
Mailing Address - Country:US
Mailing Address - Phone:914-332-5394
Mailing Address - Fax:914-332-5465
Practice Address - Street 1:200 S BROADWAY
Practice Address - Street 2:SUITE 211
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-4500
Practice Address - Country:US
Practice Address - Phone:914-332-5394
Practice Address - Fax:914-332-5465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147079207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty