MEDICARE: SALVATORE GAUDINO DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213EP1101X	Primary Podiatric Medicine Podiatrist	02607	NJ
2	213ES0131X	Foot Surgery Podiatrist	02607	NJ
3	213EP1101X	Primary Podiatric Medicine Podiatrist	005093	NY
4	213ES0131X	Foot Surgery Podiatrist	005093	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053402438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALVATORE GAUDINO DPM

Provider Business Mailing Address
First Line	:	420 74TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-2602
Country	:	US
Telephone Number	:	718-836-1017
Fax Number	:	718-836-9555

Provider Business Practice Location Address
First Line	:	420 74TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-2602
Country	:	US
Telephone Number	:	718-836-1017
Fax Number	:	718-836-9555

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	10/10/2025

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Directions to “ SALVATORE GAUDINO DPM” Practice Location

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