Provider Demographics
NPI:1518103480
Name:SALMAGGI, THERESA P
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:P
Last Name:SALMAGGI
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:THERESA
Other - Middle Name:P
Other - Last Name:MANGOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:16 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11738-1621
Mailing Address - Country:US
Mailing Address - Phone:631-698-1185
Mailing Address - Fax:
Practice Address - Street 1:16 SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:FARMINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:11738-1621
Practice Address - Country:US
Practice Address - Phone:631-698-1185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-26
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182645163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse