Provider Demographics
NPI:1073340709
Name:KHAZALEH, SALSABEEL SAHO (DPT)
Entity type:Individual
Prefix:DR
First Name:SALSABEEL
Middle Name:SAHO
Last Name:KHAZALEH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 BELLEVUE AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13219-3211
Mailing Address - Country:US
Mailing Address - Phone:315-383-5301
Mailing Address - Fax:
Practice Address - Street 1:26 CONKEY AVE
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1756
Practice Address - Country:US
Practice Address - Phone:607-337-4227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist