Stacy P Salob MD PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

187578 Issued in NY

Legal business name

STACY P SALOB MD PLLC

Practice address

115 East 61St Street
Suite #7E
New York, NY 10065

Phone

(212) 317-1100

Fax

(212) 317-1391

NPI assigned

Sep 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Stacy P Salob, M.D.

Title

Owner

Phone

(212) 317-1100

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle Goldberg Green, M.D.

  • Dermatology Physician
  • New York, NY
  • NPI 1407023369
  NPD
• Keyan Ma, MD

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
  • NPI 1467419945
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1487849865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 EAST 61ST STREET",
            "address_2": "SUITE #7E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10065",
            "telephone_number": "212-317-1100",
            "fax_number": "212-317-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 EAST 61ST STREET",
            "address_2": "SUITE #7E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10065",
            "telephone_number": "212-317-1100",
            "fax_number": "212-317-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY P SALOB MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "SALOB",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-317-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "187578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard William Stackhouse, PHD
• Sarah Alice Stackpole, M.D.
• Carol Ruane Stacks, LCSW
• Chloe Sophia Stacks
• Keyonia S Stacks
• Adrienne Stacy
• Charles B Stacy Jr., MD
• Lana N Stacy, MSAC, LAC
• Alexander Stadler, LCSW-R
• Emily Stadler

• Dermatology Physician in New York, NY
• Providers in New York, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.