MEDICARE: MS. CAROL A SALVO R.N.

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	163W00000X	Registered Nurse	340384-1	NY

General Provider Information

NPI Number	:	1275802027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROL A SALVO R.N.

Provider Business Mailing Address
First Line	:	711 JOHNSON AVE
Second Line	:
City	:	RONKONKOMA
State	:	NY
Zip	:	11779-6138
Country	:	US
Telephone Number	:	631-737-0992
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 MUR PL
Second Line	:
City	:	BRENTWOOD
State	:	NY
Zip	:	11717-2935
Country	:	US
Telephone Number	:	631-434-2406
Fax Number	:

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

Provider Enumeration Date	:	12/23/2011
Last Update Date	:	12/23/2011

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Directions to “ MS. CAROL A SALVO R.N.” Practice Location

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