Provider Demographics
NPI:1679147110
Name:SALAMONE, STACY (PSYM)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:
Last Name:SALAMONE
Suffix:
Gender:F
Credentials:PSYM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9429 BOSTON STATE RD
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:NY
Mailing Address - Zip Code:14025-9773
Mailing Address - Country:US
Mailing Address - Phone:716-226-4254
Mailing Address - Fax:
Practice Address - Street 1:2730 UNION RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14227-2212
Practice Address - Country:US
Practice Address - Phone:716-281-3870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily