Healthcare Provider Details

I. General information

NPI: 1467678516
Provider Name (Legal Business Name): EXPRESSMED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 MAIN ST
KEANSBURG NJ
07734
US

IV. Provider business mailing address

199 MAIN ST
KEANSBURG NJ
07734
US

V. Phone/Fax

Practice location:
  • Phone: 732-495-0074
  • Fax:
Mailing address:
  • Phone: 732-495-0074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JON P SALISBURY
Title or Position: OWNER
Credential: M.D.
Phone: 732-495-0074