Provider Demographics
NPI:1114588720
Name:SALIK, MUNNI (PA-C)
Entity Type:Individual
Prefix:
First Name:MUNNI
Middle Name:
Last Name:SALIK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ELEMA PL
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-1909
Mailing Address - Country:US
Mailing Address - Phone:973-968-1512
Mailing Address - Fax:
Practice Address - Street 1:32 WATERVIEW BOULEVARD
Practice Address - Street 2:SUITE A
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-7611
Practice Address - Country:US
Practice Address - Phone:862-362-1030
Practice Address - Fax:862-362-1031
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00527600363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0688835Medicaid