Provider Demographics
NPI:1295766608
Name:SALVADORI, MICHELE A (NP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:A
Last Name:SALVADORI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 HICKSVILLE RD
Mailing Address - Street 2:STE 104
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-1300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:850 HICKSVILLE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-1300
Practice Address - Country:US
Practice Address - Phone:516-798-0141
Practice Address - Fax:516-798-0694
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302329-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1237G1Medicare PIN
NYQ51770Medicare UPIN