Provider Demographics
NPI:1609034511
Name:SALERNO, ROBERT HERMAN (PN)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:HERMAN
Last Name:SALERNO
Suffix:
Gender:M
Credentials:PN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 EWING RD
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-3212
Mailing Address - Country:US
Mailing Address - Phone:330-629-8770
Mailing Address - Fax:
Practice Address - Street 1:1011 BOARDMAN CANFIELD RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-4226
Practice Address - Country:US
Practice Address - Phone:330-629-2888
Practice Address - Fax:330-629-8940
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH123412164W00000X
OH6374225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No164W00000XNursing Service ProvidersLicensed Practical Nurse