1982163317 NPI number — MS. ISABEL ROSE SALAMONE DNP

Table of content: MS. ISABEL ROSE SALAMONE DNP (NPI 1982163317)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982163317 NPI number — MS. ISABEL ROSE SALAMONE DNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALAMONE
Provider First Name:
ISABEL
Provider Middle Name:
ROSE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
DNP
Provider Gender Code:
F

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:
1982163317
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1150 NOTT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCHENECTADY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12308-2426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
183-741-6575
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1150 NOTT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHENECTADY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12308-2426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-374-1655
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/15/2019

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: 363LA2200X , with the licence number:  F309112-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: F309112-1 . This is a "LICENSE NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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