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General NPI Number Information
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NPI Number | 1588707954
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Entity Type | Organization
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Legal Business Name | SENIOR HEALTHCARE OUTREACH PROGRAM
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 613 PARK AVE FL 1
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City | EAST ORANGE
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State | NJ
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Zip | 07017-1905
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Country | US
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Telephone | 973-556-0955
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Fax | 973-675-0040
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Provider Business Mailing Address
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Address Line | 523 PARK AVE
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City | ORANGE
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State | NJ
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Zip | 07050-1703
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Country | US
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Telephone | 973-556-0955
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Fax | 973-675-0040
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALEXANDER G SALERNO
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Credential | MD
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Telephone | 973-672-8573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State | NJ
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