1356401863 NPI number — DR. JOSEPH ENRICO SALVATORE JR. M.D.

Table of content: RICHARD QI (NPI 1619495900)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356401863 NPI number — DR. JOSEPH ENRICO SALVATORE JR. M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALVATORE
Provider First Name:
JOSEPH
Provider Middle Name:
ENRICO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SALVATORE
Provider Other First Name:
RICK
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1356401863
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/26/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44 NASSAU ST STE 361
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PRINCETON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08542-4511
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-252-0777
Provider Business Mailing Address Fax Number:
609-228-4224

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 NASSAU ST
Provider Second Line Business Practice Location Address:
SUITE 512
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08542-4509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-252-0777
Provider Business Practice Location Address Fax Number:
609-252-0778
Provider Enumeration Date:
12/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  25MA075086600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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