Healthcare Provider Details

I. General information

NPI: 1134253081
Provider Name (Legal Business Name): SALOMON GALIMIDI-HODARA MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 02/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 ELMORA AVE
ELIZABETH NJ
07202-1169
US

IV. Provider business mailing address

171 ELMORA AVE
ELIZABETH NJ
07202-1169
US

V. Phone/Fax

Practice location:
  • Phone: 908-289-2239
  • Fax: 908-659-1001
Mailing address:
  • Phone: 908-289-2239
  • Fax: 908-659-1001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25 MA 04682200
License Number StateNJ

VIII. Authorized Official

Name: DR. SALOMON GALIMIDI-HODARA
Title or Position: PARTNER
Credential: MD
Phone: 908-289-2239