Provider Demographics
NPI:1043364631
Name:SALVATORE, MIRELLA (MD)
Entity Type:Individual
Prefix:DR
First Name:MIRELLA
Middle Name:
Last Name:SALVATORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 YORK AVE RM A479
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-4805
Mailing Address - Country:US
Mailing Address - Phone:212-746-6320
Mailing Address - Fax:212-746-8675
Practice Address - Street 1:1300 YORK AVE RM A479
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4805
Practice Address - Country:US
Practice Address - Phone:212-746-6913
Practice Address - Fax:212-746-8675
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233172207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease