MEDICARE: NEWARK VEIN AND VASCULAR CENTER LLC

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1174159982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEWARK VEIN AND VASCULAR CENTER LLC

Provider Business Mailing Address
First Line	:	523 PARK AVE
Second Line	:
City	:	ORANGE
State	:	NJ
Zip	:	07050-1703
Country	:	US
Telephone Number	:	862-229-1516
Fax Number	:	973-675-0040

Provider Business Practice Location Address
First Line	:	485 MOUNT PROSPECT AVE, GROUND FLOOR
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07104-2905
Country	:	US
Telephone Number	:	973-639-7546
Fax Number	:	973-675-0040

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALEXANDER SALERNO
Credential	:	MD
Telephone Number	:	973-672-2455

Provider Enumeration Date	:	03/13/2020
Last Update Date	:	03/31/2025

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