Provider Demographics
NPI:1639514755
Name:SALERNO, RALPH D (LAC)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:D
Last Name:SALERNO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 GAYMOR RD
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-3014
Mailing Address - Country:US
Mailing Address - Phone:631-265-9440
Mailing Address - Fax:
Practice Address - Street 1:3 GAYMOR RD
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-3014
Practice Address - Country:US
Practice Address - Phone:631-265-9440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004971171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist