Provider Demographics
NPI:1255543682
Name:SALISBURY, PATRICIA CHRISTOFF (MS-CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:CHRISTOFF
Last Name:SALISBURY
Suffix:
Gender:F
Credentials:MS-CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 LEMONTON WAY
Mailing Address - Street 2:
Mailing Address - City:RADNOR
Mailing Address - State:PA
Mailing Address - Zip Code:19087-4664
Mailing Address - Country:US
Mailing Address - Phone:215-817-8126
Mailing Address - Fax:
Practice Address - Street 1:96 LEMONTON WAY
Practice Address - Street 2:
Practice Address - City:RADNOR
Practice Address - State:PA
Practice Address - Zip Code:19087
Practice Address - Country:US
Practice Address - Phone:215-817-8126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2019-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000884L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001930569 0003Medicaid