Provider Demographics
NPI:1881432722
Name:SALTZMAN, MADISON (MS)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:SALTZMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 E 5TH ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-3139
Mailing Address - Country:US
Mailing Address - Phone:215-430-3696
Mailing Address - Fax:
Practice Address - Street 1:605 E 5TH ST UNIT 1
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-3139
Practice Address - Country:US
Practice Address - Phone:215-430-3696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health