Provider Demographics
NPI:1285861237
Name:SALVATORE, JOHN D (PT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:SALVATORE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 PURCHASE ST
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-2127
Mailing Address - Country:US
Mailing Address - Phone:914-921-6061
Mailing Address - Fax:
Practice Address - Street 1:266 PURCHASE ST
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-2127
Practice Address - Country:US
Practice Address - Phone:914-921-6061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist