Provider Demographics
NPI:1194718635
Name:SALZMAN, IRA J (M D)
Entity type:Individual
Prefix:DR
First Name:IRA
Middle Name:J
Last Name:SALZMAN
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4 BURKE LN
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3931
Mailing Address - Country:US
Mailing Address - Phone:516-921-6610
Mailing Address - Fax:516-921-1389
Practice Address - Street 1:4 BURKE LN
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3931
Practice Address - Country:US
Practice Address - Phone:516-921-6610
Practice Address - Fax:516-921-1389
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168245-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01189257Medicaid
NY01189257Medicaid
D92082Medicare UPIN