Provider Demographics
NPI:1871778936
Name:SALAK, JESSICA (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SALAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:687 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-1518
Mailing Address - Country:US
Mailing Address - Phone:508-222-3200
Mailing Address - Fax:508-342-1903
Practice Address - Street 1:687 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-1518
Practice Address - Country:US
Practice Address - Phone:508-222-3200
Practice Address - Fax:508-342-1903
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH091179207V00000X
RIMD13043207V00000X
MA294969207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology