Healthcare Provider Details

I. General information

NPI: 1992979397
Provider Name (Legal Business Name): JENNIFER SALCEDO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E 149TH ST
BRONX NY
10451-5504
US

IV. Provider business mailing address

40 SUNSHINE COTTAGE RD
VALHALLA NY
10595-1524
US

V. Phone/Fax

Practice location:
  • Phone: 718-578-5000
  • Fax:
Mailing address:
  • Phone: 808-203-6508
  • Fax: 808-955-2174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA102829
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD16726
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code207VC0300X
TaxonomyComplex Family Planning Physician
License NumberR4137
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207VC0300X
TaxonomyComplex Family Planning Physician
License Number315741-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: