Provider Demographics
NPI:1780119404
Name:SALIB, PAUL (MD, DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:SALIB
Suffix:
Gender:M
Credentials:MD, DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 BIRCHWOOD PARK DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-6407
Mailing Address - Country:US
Mailing Address - Phone:714-553-3370
Mailing Address - Fax:
Practice Address - Street 1:7031 SW 62ND AVE
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4701
Practice Address - Country:US
Practice Address - Phone:714-553-3370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY329191171100000X
FLOS22114171100000X, 204D00000X, 208VP0014X, 390200000X
TXU3002204D00000X
PAOS021761204D00000X
MI5101027494204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine