MEDICARE: DR. MICHAEL LAWRENCE SALITAN M.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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	166311	NY

General Provider Information

NPI Number	:	1750499810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL LAWRENCE SALITAN M.D.

Provider Business Mailing Address
First Line	:	589 BROADWAY
Second Line	:	2ND FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10012-3231
Country	:	US
Telephone Number	:	212-219-7600
Fax Number	:	212-219-8812

Provider Business Practice Location Address
First Line	:	589 BROADWAY
Second Line	:	2ND FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10012-3231
Country	:	US
Telephone Number	:	212-219-7600
Fax Number	:	212-219-8812

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	10/29/2007

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