Provider Demographics
NPI:1245474725
Name:SALVATORE GAUDINO DPM PLLC
Entity type:Organization
Organization Name:SALVATORE GAUDINO DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:C
Authorized Official - Last Name:GAUDINO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-836-1017
Mailing Address - Street 1:420 74TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-2602
Mailing Address - Country:US
Mailing Address - Phone:718-836-1017
Mailing Address - Fax:718-836-9555
Practice Address - Street 1:420 74TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-2602
Practice Address - Country:US
Practice Address - Phone:718-836-1017
Practice Address - Fax:718-836-9555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
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NY38845OtherELDERPLAN
NYP665631OtherOXFORD
NY5180176OtherAETNA PPO
NY6C4043OtherHEALTHNET
NY1833198OtherUNITED HEALTHCARE
NY2421958OtherAETNA USHC
NY51018POtherHEALTHCARE PARTNERS
NYAC8360OtherACS HEATHNET
NY01803956OtherMEDICAID
NY0685697460001OtherCIGNA
NYN005093-A85OtherHEALTHFIRST
NY10210516AOtherAMERIGROUP
NY78020685697460OtherHORIZON
NY8999989OtherGHI
NY1059721OtherFIRSTHEALTH
NY51018POtherHIP
NY5180176OtherAETNA PPO
NYN005093-A85OtherHEALTHFIRST
NY5180176OtherAETNA PPO