Healthcare Provider Details

I. General information

NPI: 1134793128
Provider Name (Legal Business Name): SALMAN TARIQ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date: 10/27/2022
Reactivation Date: 11/23/2022

III. Provider practice location address

515 MAIN ST
OLEAN NY
14760-1513
US

IV. Provider business mailing address

515 MAIN ST
OLEAN NY
14760-1513
US

V. Phone/Fax

Practice location:
  • Phone: 716-373-2600
  • Fax:
Mailing address:
  • Phone: 716-373-2600
  • Fax: 607-274-4587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberLL4274
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: