Provider Demographics
NPI:1376344820
Name:SALAS, CARLEY ELIZABETH (MS, RDN)
Entity type:Individual
Prefix:
First Name:CARLEY
Middle Name:ELIZABETH
Last Name:SALAS
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 DON DR
Mailing Address - Street 2:
Mailing Address - City:SHOHOLA
Mailing Address - State:PA
Mailing Address - Zip Code:18458-4147
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:114 DON DR
Practice Address - Street 2:
Practice Address - City:SHOHOLA
Practice Address - State:PA
Practice Address - Zip Code:18458-4147
Practice Address - Country:US
Practice Address - Phone:315-416-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010401-01133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered