Provider Demographics
NPI:1144204132
Name:SALERNO, ELENA (MD)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:SALERNO
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 1:4121 DUTCHMANS LANE
Mailing Address - Street 2:SUITE 601
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207
Mailing Address - Country:US
Mailing Address - Phone:502-895-6559
Mailing Address - Fax:502-895-8994
Practice Address - Street 1:4121 DUTCHMANS LANE
Practice Address - Street 2:SUITE 601
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-895-6559
Practice Address - Fax:502-895-8994
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34988207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY610679864FOtherHUMANA
KY1136271Medicaid
KY160046025OtherRR MEDICARE
KY000000066466OtherBCBS
KY1269707Medicare ID - Type Unspecified
KY160046025OtherRR MEDICARE