Provider Demographics
NPI:1508829706
Name:SALERNO, LAURIE A (ANP)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:A
Last Name:SALERNO
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 NW 167TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5710
Mailing Address - Country:US
Mailing Address - Phone:757-533-9441
Mailing Address - Fax:757-446-1454
Practice Address - Street 1:549 E BRAMBLETON AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-2905
Practice Address - Country:US
Practice Address - Phone:757-533-9441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302915-1363LA2200X
VA0024171474363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ00026496401OtherUNIVERA
NM02154694Medicaid
NJ166192295OtherGHI
NY166192295OtherEMPIRE
NY500019800OtherRAILROAD MEDICARE
NY000560568001OtherBLUE CROSS
NJ9512165OtherINDEPENDENT HEALTH
NY000560568001OtherCOMMUNITY BLUE
NY500019800OtherRAILROAD MEDICARE
NJ00026496401OtherUNIVERA