Healthcare Provider Details

I. General information

NPI: 1053593814
Provider Name (Legal Business Name): HEATHER LEANNE SALVAGGIO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 SAINT CHARLES WAY
YORK PA
17402-4643
US

IV. Provider business mailing address

205 SAINT CHARLES WAY
YORK PA
17402-4643
US

V. Phone/Fax

Practice location:
  • Phone: 717-741-4666
  • Fax: 717-741-9649
Mailing address:
  • Phone: 717-741-4666
  • Fax: 717-741-9649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number265454
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License Number265454
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD456279
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: