Healthcare Provider Details

I. General information

NPI: 1063121309
Provider Name (Legal Business Name): CARA ELVIRA SALVATORE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2022
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2090 ADAM CLAYTON POWELL JR BLVD FL 4
NEW YORK NY
10027-4941
US

IV. Provider business mailing address

45 TUDOR CITY PL APT 618
NEW YORK NY
10017-7604
US

V. Phone/Fax

Practice location:
  • Phone: 212-553-6708
  • Fax:
Mailing address:
  • Phone: 212-603-9182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number117823-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: