Provider Demographics
NPI:1891816831
Name:SALOMON, EMIL (OD)
Entity Type:Individual
Prefix:
First Name:EMIL
Middle Name:
Last Name:SALOMON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HEMPSTEAD AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-1614
Mailing Address - Country:US
Mailing Address - Phone:516-599-2626
Mailing Address - Fax:
Practice Address - Street 1:50 HEMPSTEAD AVE
Practice Address - Street 2:SUITE D
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-1614
Practice Address - Country:US
Practice Address - Phone:516-599-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT2370152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
42859340OtherUNITED HEALTHCARE
90528OtherAETNA
90528OtherAETNA
C93691Medicare ID - Type Unspecified