MEDICARE: DR. CONSTANCE SALHANY PH.D.

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	103TC0700X	Clinical Psychologist	017286	NY

General Provider Information

NPI Number	:	1205036217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CONSTANCE SALHANY PH.D.

Provider Business Mailing Address
First Line	:	1110 SOUTH AVENUE AT LOIS LANE
Second Line	:	SUITE # 5
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314
Country	:	US
Telephone Number	:	347-217-8729
Fax Number	:	718-227-6007

Provider Business Practice Location Address
First Line	:	1110 SOUTH AVE
Second Line	:	SUITE 5
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3403
Country	:	US
Telephone Number	:	347-217-8729
Fax Number	:	718-227-6007

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

Provider Enumeration Date	:	07/19/2007
Last Update Date	:	12/02/2010

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