Healthcare Provider Details

I. General information

NPI: 1699636159
Provider Name (Legal Business Name): MR. ANTHONY FRANK SALERNO III
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2025
Last Update Date: 11/22/2025
Certification Date: 11/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 FOOTE HILL RD
NORTHFORD CT
06472-1367
US

IV. Provider business mailing address

74 FOOTE HILL RD
NORTHFORD CT
06472-1367
US

V. Phone/Fax

Practice location:
  • Phone: 203-214-0182
  • Fax:
Mailing address:
  • Phone: 203-214-0182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number4046
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: