Provider Demographics
NPI:1639980741
Name:ANISSA SALERNO
Entity type:Organization
Organization Name:ANISSA SALERNO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:ANISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALERNO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:301-241-6070
Mailing Address - Street 1:712 S KEYSER AVE UNIT 5-6
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:PA
Mailing Address - Zip Code:18517-9612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:712 S KEYSER AVE UNIT 5-6
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:PA
Practice Address - Zip Code:18517-9612
Practice Address - Country:US
Practice Address - Phone:301-241-6070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty