Provider Demographics
NPI:1194838060
Name:SALERNO, CHRISTOPHER (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:SALERNO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 SUNSET RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-3645
Mailing Address - Country:US
Mailing Address - Phone:609-387-9242
Mailing Address - Fax:609-387-9408
Practice Address - Street 1:1 MAINBRIDGE LN
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-2103
Practice Address - Country:US
Practice Address - Phone:609-877-0644
Practice Address - Fax:609-877-0370
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB68116207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8267405Medicaid
NJ8267405Medicaid
038073Medicare ID - Type Unspecified