Provider Demographics
NPI:1063005239
Name:SALVATORE, ALINA
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:SALVATORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1181 OLD COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-1810
Mailing Address - Country:US
Mailing Address - Phone:301-802-6140
Mailing Address - Fax:
Practice Address - Street 1:1181 OLD COUNTY RD
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-1810
Practice Address - Country:US
Practice Address - Phone:301-802-6140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist