Provider Demographics
NPI:1548618010
Name:ZACHARIA-SALVI, JILL
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:
Last Name:ZACHARIA-SALVI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 WISTERIA DRIVE
Mailing Address - Street 2:PO BOX 1062
Mailing Address - City:REMSENBURG
Mailing Address - State:NY
Mailing Address - Zip Code:11960
Mailing Address - Country:US
Mailing Address - Phone:917-826-7016
Mailing Address - Fax:
Practice Address - Street 1:13 WISTERIA DRIVE
Practice Address - Street 2:
Practice Address - City:REMSENBURG
Practice Address - State:NY
Practice Address - Zip Code:11960
Practice Address - Country:US
Practice Address - Phone:917-826-7016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program