1407946189 NPI number — DR. ANTHONY L SALIERNO M.D.

Table of content: DR. ANTHONY L SALIERNO M.D. (NPI 1407946189)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407946189 NPI number — DR. ANTHONY L SALIERNO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALIERNO
Provider First Name:
ANTHONY
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
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:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407946189
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
535 SASYBROOK ROAD
Provider Second Line Business Mailing Address:
GROUND FLOOR
Provider Business Mailing Address City Name:
MIDDLETOWN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06457-4711
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-347-9377
Provider Business Mailing Address Fax Number:
860-347-4146

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
535 SAYBROOK ROAD
Provider Second Line Business Practice Location Address:
GROUND FLOOR
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06457-4711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-347-9377
Provider Business Practice Location Address Fax Number:
860-347-4146
Provider Enumeration Date:
10/13/2006

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: 174400000X , with the licence number:  039619 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: 039619 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207W00000X , with the licence number: 39819 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 020553664 . This is a "CHN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 001396193-01 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001396193 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004172821 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010039619CT06 . This is a "ANTHEM" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 9684734 . This is a "GHI" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008242 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 5611815 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P2548379 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 020553664 . This is a "CIGNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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