Provider Demographics
NPI:1295079234
Name:SALTZMAN, DANIEL RAOUL
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:RAOUL
Last Name:SALTZMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 BREWERTON RD
Mailing Address - Street 2:BOX 3843
Mailing Address - City:WEST POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10996-1602
Mailing Address - Country:US
Mailing Address - Phone:734-904-9575
Mailing Address - Fax:
Practice Address - Street 1:3182 FAIRCHILD AVE UNIT E
Practice Address - Street 2:
Practice Address - City:JBER
Practice Address - State:AK
Practice Address - Zip Code:99506-1545
Practice Address - Country:US
Practice Address - Phone:734-904-9575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY413026146L00000X
MI1620749146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic