Provider Demographics
NPI:1053419028
Name:ABBASEY, SALMAN (MD)
Entity type:Individual
Prefix:
First Name:SALMAN
Middle Name:
Last Name:ABBASEY
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 1:4263 LAKEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:NY
Mailing Address - Zip Code:14454-1179
Mailing Address - Country:US
Mailing Address - Phone:585-243-0550
Mailing Address - Fax:
Practice Address - Street 1:4263 LAKEVILLE RD
Practice Address - Street 2:
Practice Address - City:GENESEO
Practice Address - State:NY
Practice Address - Zip Code:14454-1179
Practice Address - Country:US
Practice Address - Phone:585-243-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2008-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231805207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01923248Medicaid
NY01923248Medicaid
NYBB4636Medicare PIN