Provider Demographics
NPI:1295067551
Name:SALOTTI, MICHAEL J (RPH)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:SALOTTI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 CANANDAIGUA RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-2003
Mailing Address - Country:US
Mailing Address - Phone:315-781-7784
Mailing Address - Fax:315-789-0968
Practice Address - Street 1:815 CANANDAIGUA RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-2003
Practice Address - Country:US
Practice Address - Phone:315-781-7784
Practice Address - Fax:315-789-0968
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023612183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist