Provider Demographics
NPI:1053671180
Name:JENNIFER SALVO, O.D.
Entity Type:Organization
Organization Name:JENNIFER SALVO, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SALVO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:508-740-0706
Mailing Address - Street 1:PO BOX J
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-0309
Mailing Address - Country:US
Mailing Address - Phone:508-823-9307
Mailing Address - Fax:
Practice Address - Street 1:1241 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2615
Practice Address - Country:US
Practice Address - Phone:781-444-0244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty