Healthcare Provider Details

I. General information

NPI: 1316201924
Provider Name (Legal Business Name): MARION K SALOMON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2012
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3961 DAVID PL
SEAFORD NY
11783-1520
US

IV. Provider business mailing address

3961 DAVID PL
SEAFORD NY
11783-1520
US

V. Phone/Fax

Practice location:
  • Phone: 516-785-5288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. GINAMARIE PONZO-LOZITO
Title or Position: SPECIAL EDUCATION THERAPIST
Credential: MS
Phone: 516-731-5588