Provider Demographics
NPI:1598921645
Name:SALERNO, MARIANA V (MD)
Entity Type:Individual
Prefix:
First Name:MARIANA
Middle Name:V
Last Name:SALERNO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5532 EL CAJON BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-3642
Mailing Address - Country:US
Mailing Address - Phone:619-286-1426
Mailing Address - Fax:619-286-1441
Practice Address - Street 1:5532 EL CAJON BLVD STE 1
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-3642
Practice Address - Country:US
Practice Address - Phone:619-286-1426
Practice Address - Fax:619-286-1441
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249673207R00000X
CAA131021207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400013915Medicare PIN
NYA400011040Medicare PIN