Provider Demographics
NPI:1518092352
Name:SALISBURY MEDICAL PRACTICE, P.C.
Entity Type:Organization
Organization Name:SALISBURY MEDICAL PRACTICE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JED
Authorized Official - Middle Name:A
Authorized Official - Last Name:HANTVERK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-433-0770
Mailing Address - Street 1:123 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-6131
Mailing Address - Country:US
Mailing Address - Phone:516-433-0770
Mailing Address - Fax:516-433-0820
Practice Address - Street 1:123 STEWART AVE
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-6131
Practice Address - Country:US
Practice Address - Phone:516-433-0770
Practice Address - Fax:516-433-0820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty