Healthcare Provider Details

I. General information

NPI: 1518305739
Provider Name (Legal Business Name): JENNIFER ANN SALANT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2013
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST # 139
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

525 E 68TH ST # 139
NEW YORK NY
10065-4870
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-1220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number297897
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080H0002X
TaxonomyPediatric Hospice and Palliative Medicine Physician
License Number297897
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: