Provider Demographics
NPI:1548289309
Name:SALEM, ALAN ABRAHAM (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ABRAHAM
Last Name:SALEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3051 LONG BEACH RD
Mailing Address - Street 2:SUITE#1
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-3240
Mailing Address - Country:US
Mailing Address - Phone:516-536-2000
Mailing Address - Fax:516-764-0257
Practice Address - Street 1:3051 LONG BEACH RD
Practice Address - Street 2:SUITE#1
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-3240
Practice Address - Country:US
Practice Address - Phone:516-536-2000
Practice Address - Fax:516-764-0257
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185047-12080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY185047-1OtherLICENSE #