Healthcare Provider Details

I. General information

NPI: 1306176664
Provider Name (Legal Business Name): GRETCHEN ELIZABETH SALKOWSKI RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GRETCHEN ELIZABETH GOFF CRTT

II. Dates (important events)

Enumeration Date: 01/10/2010
Last Update Date: 01/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4404 FITCH AVE
BALTIMORE MD
21236-3907
US

IV. Provider business mailing address

4404 FITCH AVE
BALTIMORE MD
21236-3907
US

V. Phone/Fax

Practice location:
  • Phone: 410-665-0107
  • Fax:
Mailing address:
  • Phone: 410-665-0107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License NumberL000847
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License NumberC9-0000743
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License NumberYM011393
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: