Provider Demographics
NPI:1235696659
Name:SALISBURY, MEREDITH CLAIRE (MSW)
Entity Type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:CLAIRE
Last Name:SALISBURY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5717
Mailing Address - Country:US
Mailing Address - Phone:315-790-0257
Mailing Address - Fax:
Practice Address - Street 1:1612 GENESEE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5425
Practice Address - Country:US
Practice Address - Phone:315-724-5173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program