MEDICARE: JELI SALAU

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	183500000X	Pharmacist	19592	MD

General Provider Information

NPI Number	:	1366755431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JELI SALAU

Provider Business Mailing Address
First Line	:	3110 KYLE AVE
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-2566
Country	:	US
Telephone Number	:	301-523-6518
Fax Number	:

Provider Business Practice Location Address
First Line	:	3110 KYLE AVE
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-2566
Country	:	US
Telephone Number	:	301-523-6518
Fax Number	:

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

Provider Enumeration Date	:	07/19/2010
Last Update Date	:	07/19/2010

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Directions to “ JELI SALAU ” Practice Location

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