Provider Demographics
NPI:1790900603
Name:SALZBERG, CAROL (NP-P)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:SALZBERG
Suffix:
Gender:F
Credentials:NP-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 NEW PALTZ RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-1023
Mailing Address - Country:US
Mailing Address - Phone:845-691-8397
Mailing Address - Fax:
Practice Address - Street 1:47 W MARKET ST
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1417
Practice Address - Country:US
Practice Address - Phone:845-876-4017
Practice Address - Fax:845-876-5726
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400411-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMS0372021OtherDEA