MEDICARE: MS. SALATHIA SHAVON MIXON

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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1649734690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SALATHIA SHAVON MIXON

Provider Business Mailing Address
First Line	:	1519 METROPOLITAN AVE APT 6G
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-6121
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1519 METROPOLITAN AVE APT 6G
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-6121
Country	:	US
Telephone Number	:	347-256-0976
Fax Number	:

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

Provider Enumeration Date	:	01/24/2019
Last Update Date	:	01/24/2019

Similar Medicare Providers

1326532979 — KRYSTAL ORTIZ
Practice Location Address:

2503 WESTERVELT AVE
BRONX, NY
10469-6121

Practice Phone: 917-809-0127
Practice Fax:

1649127721 — JOHN O'CONNELL LMSW
Practice Location Address:

1610 METROPOLITAN AVE APT 1F
BRONX, NY
10462-6934

Practice Phone: 718-792-1177
Practice Fax:

1831047976 — MR. NEBIL SOUMARE
Practice Location Address:

1538 PURDY ST
BRONX, NY
10462-4216

Practice Phone: 917-650-1370
Practice Fax:

1477409753 — DAVID WELLNESS ENTERPRISE INC
Practice Location Address:

740 MORRIS PARK AVE
BRONX, NY
10462-3620

Practice Phone: 877-609-3035
Practice Fax:

1598610982 — ANDERLIN LOPEZ
Practice Location Address:

900 LYDIG AVE
BRONX, NY
10462-2149

Practice Phone: 929-474-4887
Practice Fax:

1598610776 — MS. STEPHANIE NICOLE GARCIA
Practice Location Address:

1514 UNIONPORT RD APT 4H
BRONX, NY
10462-7847

Practice Phone: 917-484-1722
Practice Fax:

Directions to “ MS. SALATHIA SHAVON MIXON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.