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General NPI Number Information
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NPI Number | 1043531882
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Entity Type | Individual
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Provider Name | ALICIA ANN SALAS D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/16/2010
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 1275 SUMMER ST. SUITE 301
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City | STAMFORD
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State | CT
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Zip | 06905
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Country | US
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Telephone | 203-324-4109
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Fax | 203-969-1271
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Provider Business Mailing Address
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Address Line | 1275 SUMMER ST. SUITE 301
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City | STAMFORD
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State | CT
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Zip | 06905
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Country | US
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Telephone | 203-324-4109
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Fax | 203-969-1271
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MB09315100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 056487
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License Number State | CT
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