Healthcare Provider Details

I. General information

NPI: 1275792947
Provider Name (Legal Business Name): LEE HIRAM SALTZMAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 08/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 W END AVE
NEW YORK NY
10024-1715
US

IV. Provider business mailing address

PO BOX 250256
NEW YORK NY
10025-1534
US

V. Phone/Fax

Practice location:
  • Phone: 646-319-7498
  • Fax:
Mailing address:
  • Phone: 646-319-7498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number017651
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number2173181
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: