Healthcare Provider Details

I. General information

NPI: 1235178872
Provider Name (Legal Business Name): MICHAEL ENDRODI SALACZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MICHAEL SALACZ DOHNANYI

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CENTENNIAL BLVD BLDG 1
VOORHEES NJ
08043-4637
US

IV. Provider business mailing address

1 FEDERAL ST STE 200
CAMDEN NJ
08103-1088
US

V. Phone/Fax

Practice location:
  • Phone: 855-632-2667
  • Fax:
Mailing address:
  • Phone: 848-288-6935
  • Fax: 732-790-0109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA10982500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number25MA10982500
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number25MA10982500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: