Provider Demographics
NPI:1992855654
Name:SALVATORIELLO, NORA CUISON
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:CUISON
Last Name:SALVATORIELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:CARVAJAL
Other - Last Name:CUISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26 DICK ST
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1215
Mailing Address - Country:US
Mailing Address - Phone:718-579-5717
Mailing Address - Fax:
Practice Address - Street 1:#26 DICK STREET
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621
Practice Address - Country:US
Practice Address - Phone:718-579-5717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303454-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health