Basic Information
| Provider Information | |||||||||
| NPI: | 1093895773 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SALTZMAN | ||||||||
| FirstName: | MARTIN | ||||||||
| MiddleName: | JAY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 630 WEST 168TH STREET | ||||||||
| Address2: | BOX 4 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9143373500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3 MICHAEL FREY DR | ||||||||
| Address2: | |||||||||
| City: | EASTCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107092725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9143373500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 118532 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | 118532 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 00594427 | 05 | NY | MEDICAID |