Healthcare Provider Details

I. General information

NPI: 1336462365
Provider Name (Legal Business Name): PAULA JEAN SALERNO P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2010
Last Update Date: 03/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 N HIGH ST
EAST HAVEN CT
06512-1555
US

IV. Provider business mailing address

451 N HIGH ST
EAST HAVEN CT
06512-1555
US

V. Phone/Fax

Practice location:
  • Phone: 203-466-6850
  • Fax: 203-466-6852
Mailing address:
  • Phone: 203-466-6850
  • Fax: 203-466-6852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number6061
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: