Provider Demographics
NPI:1205863636
Name:SALOMON, JEFFREY C (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:C
Last Name:SALOMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 AMITY RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2258
Mailing Address - Country:US
Mailing Address - Phone:203-624-4346
Mailing Address - Fax:203-562-3221
Practice Address - Street 1:245 AMITY RD STE 108
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2258
Practice Address - Country:US
Practice Address - Phone:203-624-4346
Practice Address - Fax:203-562-3221
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG44313208200000X
CT22604208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
240000042Medicare ID - Type Unspecified
B84575Medicare UPIN