Provider Demographics
NPI:1477557759
Name:INFANTINO, SALVATORE (MD)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:
Last Name:INFANTINO
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 1:11-26 SADDLE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-5634
Mailing Address - Country:US
Mailing Address - Phone:201-796-9200
Mailing Address - Fax:201-796-7606
Practice Address - Street 1:11-26 SADDLE RIVER RD
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-5634
Practice Address - Country:US
Practice Address - Phone:201-796-9225
Practice Address - Fax:201-796-7606
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA041348207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ109738OtherCROWN CORK AND SEAL
NJ0K2007OtherHEALTHNET
92A25OtherWELLCHOICE
NJP686347OtherOXFORD
92A25OtherEMPIRE BLUE CROSS
NJ221868199OtherTAX ID
376426OtherMVP
NJ001448029001OtherUNITED HEALTHCARE
NJ4274472OtherAETNA
NJ109783CF8Medicare PIN
NJ0K2007OtherHEALTHNET
NJP686347OtherOXFORD