=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447934369
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIAN REED SALKIND MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2023
-----------------------------------------------------
Last Update Date | 03/20/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3401 N BROAD ST
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19140-5189
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-707-2000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1165 WRACK RD
-----------------------------------------------------
City | MEADOWBROOK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19046-2543
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-870-8690
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | MT227965
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------