Provider Demographics
NPI:1295255511
Name:SALTARES, CAROLINA (MA, SLP, TSSLD, BE)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:SALTARES
Suffix:
Gender:F
Credentials:MA, SLP, TSSLD, BE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 E 152ND ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5105
Mailing Address - Country:US
Mailing Address - Phone:718-299-3700
Mailing Address - Fax:
Practice Address - Street 1:335 E 152ND ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5105
Practice Address - Country:US
Practice Address - Phone:718-299-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028474-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist