Healthcare Provider Details

I. General information

NPI: 1396020137
Provider Name (Legal Business Name): DR. KIMBERLEY MCGRATH SALAMONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2011
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 GARRISON WOODS LN
WALLKILL NY
12589-4040
US

IV. Provider business mailing address

324 GARRISON WOODS LN
WALLKILL NY
12589-4040
US

V. Phone/Fax

Practice location:
  • Phone: 845-913-6562
  • Fax: 845-913-9467
Mailing address:
  • Phone: 845-913-6562
  • Fax: 845-913-9467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0789311
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number078931-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: