Provider Demographics
NPI:1861680910
Name:SALTZMAN, LOIS S (MD)
Entity Type:Individual
Prefix:DR
First Name:LOIS
Middle Name:S
Last Name:SALTZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 973
Mailing Address - Street 2:135 ECHO AVENUE
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-0973
Mailing Address - Country:US
Mailing Address - Phone:631-875-9867
Mailing Address - Fax:631-642-0627
Practice Address - Street 1:135 ECHO AVE
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2205
Practice Address - Country:US
Practice Address - Phone:631-875-9867
Practice Address - Fax:631-642-0627
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY183870208100000X, 2081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF33648Medicare UPIN