Healthcare Provider Details

I. General information

NPI: 1265502553
Provider Name (Legal Business Name): SALVATORE PRESTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 SCHERMERHORN ST
BROOKLYN NY
11201-4824
US

IV. Provider business mailing address

25 SCHERMERHORN ST
BROOKLYN NY
11201-4824
US

V. Phone/Fax

Practice location:
  • Phone: 718-923-1123
  • Fax: 718-522-0076
Mailing address:
  • Phone: 718-923-1123
  • Fax: 718-522-0076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number148403
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: