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NPI Code Detail

MEDICARE: MARY A SALAZAR

MEDICARE: MARY A SALAZAR
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1336420579
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY A SALAZAR
Provider Business Mailing Address
First Line : 1670 E 17TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-1281
Country : US
Telephone Number : 718-375-1200
Fax Number : 718-382-3358
Provider Business Practice Location Address
First Line : 819 GRAND ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11211-5001
Country : US
Telephone Number : 718-388-5176
Fax Number : 718-388-6159
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2011
Last Update Date : 09/01/2011

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Directions to “ MARY A SALAZAR ” Practice Location

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