Provider Demographics
NPI:1093712077
Name:SALVAMOSER, KRISTEN M (RPA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:M
Last Name:SALVAMOSER
Suffix:
Gender:F
Credentials:RPA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8000
Mailing Address - Street 2:DEPT 164
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14267-0002
Mailing Address - Country:US
Mailing Address - Phone:716-692-3302
Mailing Address - Fax:716-213-0935
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:719-859-1345
Practice Address - Fax:716-859-4631
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY008809363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRAPA0359Medicare ID - Type Unspecified
NYP74455Medicare UPIN