MEDICARE: GREGORY SALMON NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	401852	NY

General Provider Information

NPI Number	:	1265700983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY SALMON NP

Provider Business Mailing Address
First Line	:	3211
Second Line	:	Q3
City	:	AUGUSTA
State	:	GA
Zip	:	30909
Country	:	US
Telephone Number	:	201-406-8840
Fax Number	:

Provider Business Practice Location Address
First Line	:	5521 CHESTER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-5334
Country	:	US
Telephone Number	:	856-360-5659
Fax Number	:	229-231-0227

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2011
Last Update Date	:	09/17/2025

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