Healthcare Provider Details

I. General information

NPI: 1154025948
Provider Name (Legal Business Name): REBECCA SALERNO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 SAYBROOK RD STE 100
MIDDLETOWN CT
06457-4788
US

IV. Provider business mailing address

99 HIGHWAY 37 W
TOMS RIVER NJ
08755-6423
US

V. Phone/Fax

Practice location:
  • Phone: 732-557-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1217
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: