Provider Demographics
NPI:1639160005
Name:SALWEN, LAURA V
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:V
Last Name:SALWEN
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 1:2732 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-1702
Mailing Address - Country:US
Mailing Address - Phone:716-838-2440
Mailing Address - Fax:716-652-0397
Practice Address - Street 1:2732 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-1702
Practice Address - Country:US
Practice Address - Phone:716-838-2440
Practice Address - Fax:716-652-0397
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYSPR0216461104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
5705459OtherAETNA
NY000508372001OtherBLUE CROSS BLUE SHIELD
7492738OtherGHI
NY6207828OtherINDEPENDENT HEALTH
7492738OtherGHI