Provider Demographics
NPI:1023464252
Name:SALAMANCA, H. HANS (MD PHD)
Entity type:Individual
Prefix:
First Name:H. HANS
Middle Name:
Last Name:SALAMANCA
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:H. HANS
Other - Middle Name:
Other - Last Name:SALAMANCA-GRANADOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD PHD
Mailing Address - Street 1:757 WARREN RD UNIT 4412
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14852-7041
Mailing Address - Country:US
Mailing Address - Phone:607-280-7646
Mailing Address - Fax:
Practice Address - Street 1:101 HARRIS B DATES DR
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1383
Practice Address - Country:US
Practice Address - Phone:607-280-7646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290877-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology