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

Last updated

Oct 7, 2011By the provider in NPPES

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.NPI 1194776435

Title

Owner

Phone

(212) 317-1100

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stacy P Salob, M.D.

  • Dermatology Physician
  • Harrison, NY
  • NPI 1194776435
  Authorized official Same address or phone
• 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.