Provider Demographics
NPI:1871629816
Name:SALOMONE, JOSEPH MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:SALOMONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 FAIRFAX ROAD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-4005
Mailing Address - Country:US
Mailing Address - Phone:802-524-2779
Mailing Address - Fax:802-524-6587
Practice Address - Street 1:53 FAIRFAX ROAD
Practice Address - Street 2:SUITE #2
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-4005
Practice Address - Country:US
Practice Address - Phone:802-524-2779
Practice Address - Fax:802-524-6587
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420009286208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN1372Medicaid
VN1372Medicare ID - Type Unspecified
G29205Medicare UPIN