Healthcare Provider Details

I. General information

NPI: 1902061187
Provider Name (Legal Business Name): KRISTIN MARIE SALOTTI N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2008
Last Update Date: 07/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 NELSON ST SUITE 240
AUBURN NY
13021-1944
US

IV. Provider business mailing address

5 NEEDHAM AVE
PHELPS NY
14532-9612
US

V. Phone/Fax

Practice location:
  • Phone: 315-252-0810
  • Fax: 315-252-5179
Mailing address:
  • Phone: 315-945-0115
  • Fax: 315-548-3692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF304925-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF304925-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: