Provider Demographics
NPI:1730668203
Name:SALUNGA, ALEX
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:SALUNGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 GREENTREE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1130
Mailing Address - Country:US
Mailing Address - Phone:856-528-5360
Mailing Address - Fax:856-520-8150
Practice Address - Street 1:114 HAYES MILL RD
Practice Address - Street 2:
Practice Address - City:ATCO
Practice Address - State:NJ
Practice Address - Zip Code:08004-2457
Practice Address - Country:US
Practice Address - Phone:856-809-7242
Practice Address - Fax:856-809-7269
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00617000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist