Healthcare Provider Details

I. General information

NPI: 1235163999
Provider Name (Legal Business Name): KAREN I SALOMON-ESCOTO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN I SALOMON-FERRERA M.D.

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 BELMONT ST MEMORIAL CAMPUS, DIVISION OF RHEUMATOLOGY
WORCESTER MA
01605-2903
US

IV. Provider business mailing address

PO BOX 415348
BOSTON MA
02241-5348
US

V. Phone/Fax

Practice location:
  • Phone: 508-334-5224
  • Fax: 508-334-5654
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number226941
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number226941
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier110079974A
Identifier TypeMEDICAID
Identifier StateMA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: