Healthcare Provider Details

I. General information

NPI: 1467630772
Provider Name (Legal Business Name): THOMAS P. SALMON D.P.M.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 HEMPSTEAD TPKE SUITE#100
BETHPAGE NY
11714-5700
US

IV. Provider business mailing address

4230 HEMPSTEAD TPKE SUITE#100
BETHPAGE NY
11714-5700
US

V. Phone/Fax

Practice location:
  • Phone: 516-796-7800
  • Fax: 516-796-7082
Mailing address:
  • Phone: 516-796-7800
  • Fax: 516-796-7082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberN004485
License Number StateNY

VIII. Authorized Official

Name: DR. THOMAS P SALMON
Title or Position: OWNER
Credential: D.P.M. F.A.C.F.A.S.
Phone: 516-796-7800