Provider Demographics
NPI:1023062973
Name:SALVEMINI, JOANN N (MD)
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:N
Last Name:SALVEMINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 NORTHERN BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5323
Mailing Address - Country:US
Mailing Address - Phone:516-773-4500
Mailing Address - Fax:516-773-9896
Practice Address - Street 1:1320 STONY BROOK RD STE 200
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790
Practice Address - Country:US
Practice Address - Phone:631-444-4200
Practice Address - Fax:631-444-4276
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190339207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G03668Medicare UPIN
160611Medicare ID - Type Unspecified