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General NPI Number Information
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NPI Number | 1699757898
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Entity Type | Individual
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Provider Name | EUGENE L DESALVO MD
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Gender | Male
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 515 IRON BRIDGE RD
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City | FREEHOLD
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State | NJ
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Zip | 07728-5300
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Country | US
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Telephone | 732-780-3434
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Fax | 732-780-9334
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Provider Business Mailing Address
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Address Line | 515 IRON BRIDGE RD
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City | FREEHOLD
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State | NJ
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Zip | 07728-5300
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Country | US
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Telephone | 732-780-3434
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Fax | 732-780-9334
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | MA31852
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License Number State | NJ
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