MEDICARE: ERICA SALERNO

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	163W00000X	Registered Nurse	704686	NY

General Provider Information

NPI Number	:	1255717880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA SALERNO

Provider Business Mailing Address
First Line	:	24 HERITAGE DR APT A
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-5317
Country	:	US
Telephone Number	:	845-536-4923
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 HERITAGE DR APT A
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-5317
Country	:	US
Telephone Number	:	845-536-4923
Fax Number	:

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

Provider Enumeration Date	:	08/05/2015
Last Update Date	:	08/05/2015

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