Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 020505 | NY |
Y | 2251P0200X | Physical Therapist - Pediatrics | 020505 | NY |
NPI | 1073768479 |
---|---|
Provider Name | Mr. David Craig Salzberg |
First Address | Staten Island, NY 10305-2809 |
Second Address | Staten Island, NY 10305-2809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2008 |
Last Update Date | 26/11/2008 |