Healthcare Provider Details

I. General information

NPI: 1235078817
Provider Name (Legal Business Name): SALUS MEDICAL ARTS P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1976 CROTONA PKWY
BRONX NY
10460-1526
US

IV. Provider business mailing address

3059 BRIGHTON 13TH ST
BROOKLYN NY
11235-5607
US

V. Phone/Fax

Practice location:
  • Phone: 718-928-7099
  • Fax:
Mailing address:
  • Phone: 718-891-7100
  • Fax: 718-891-3834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. VALENTIN AVANESSOV
Title or Position: DOCTOR
Credential: MD
Phone: 718-891-7100