Provider Demographics
NPI:1699361022
Name:SALOMONE, DANIELLE ALINE (PA-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ALINE
Last Name:SALOMONE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:VT
Mailing Address - Zip Code:05488-8094
Mailing Address - Country:US
Mailing Address - Phone:802-782-4405
Mailing Address - Fax:
Practice Address - Street 1:26 CANADA ST
Practice Address - Street 2:
Practice Address - City:SWANTON
Practice Address - State:VT
Practice Address - Zip Code:05488-1335
Practice Address - Country:US
Practice Address - Phone:802-255-5518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-20
Last Update Date:2023-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT055.0031551207QA0401X, 207QG0300X, 207QA0000X, 207QA0505X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine