MEDICARE: SYIM SALAHUDDIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1245174267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYIM SALAHUDDIN

Provider Business Mailing Address
First Line	:	1079 W BENTON ST APT 18
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52246-5962
Country	:	US
Telephone Number	:	475-234-8851
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 STATION PLZ N STE 509
Second Line	:
City	:	MINEOLA
State	:	NY
Zip	:	11501-3893
Country	:	US
Telephone Number	:	475-234-8851
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2026
Last Update Date	:	04/18/2026

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Directions to “ SYIM SALAHUDDIN ” Practice Location

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