Provider Demographics
NPI:1205593845
Name:SALVATORE, KAREN ROSE
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ROSE
Last Name:SALVATORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7715 STONE RD
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:NY
Mailing Address - Zip Code:13492-4027
Mailing Address - Country:US
Mailing Address - Phone:315-272-3553
Mailing Address - Fax:
Practice Address - Street 1:1445 KEMBLE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-4441
Practice Address - Country:US
Practice Address - Phone:315-732-0100
Practice Address - Fax:315-927-1836
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167982164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse