Provider Demographics
NPI:1417010141
Name:SALMOND, GREGORY R (DC)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:R
Last Name:SALMOND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 ROUTE 206
Mailing Address - Street 2:
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9081
Mailing Address - Country:US
Mailing Address - Phone:973-927-8522
Mailing Address - Fax:973-927-9888
Practice Address - Street 1:272 ROUTE 206
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9081
Practice Address - Country:US
Practice Address - Phone:973-927-8522
Practice Address - Fax:973-927-9888
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-17
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ520325Medicare PIN
NJT45663Medicare UPIN