Provider Demographics
NPI:1568717700
Name:SALVODON, GISELE (MS ED)
Entity Type:Individual
Prefix:MRS
First Name:GISELE
Middle Name:
Last Name:SALVODON
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:MS
Other - First Name:GISELE
Other - Middle Name:
Other - Last Name:SALVODON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1188 E 40TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4426
Mailing Address - Country:US
Mailing Address - Phone:646-483-9799
Mailing Address - Fax:
Practice Address - Street 1:1188 E 40TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4426
Practice Address - Country:US
Practice Address - Phone:646-483-9799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist