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NPI Code Detail

MEDICARE: DR. SALVATORE INFANTINO MD

MEDICARE:  DR. SALVATORE  INFANTINO  MD
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
1207QA0505XAdult Medicine PhysicianMA041348NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1109738OTHERNJCROWN CORK AND SEAL
20K2007OTHERNJHEALTHNET
392A25OTHERWELLCHOICE
4P686347OTHERNJOXFORD
592A25OTHEREMPIRE BLUE CROSS
6221868199OTHERNJTAX ID
7376426OTHERMVP
8001448029001OTHERNJUNITED HEALTHCARE
94274472OTHERNJAETNA

General Provider Information

NPI Number : 1477557759
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SALVATORE INFANTINO MD
Provider Business Mailing Address
First Line : 11-26 SADDLE RIVER RD
Second Line :
City : FAIR LAWN
State : NJ
Zip : 07410-5634
Country : US
Telephone Number : 201-796-9200
Fax Number : 201-796-7606
Provider Business Practice Location Address
First Line : 11-26 SADDLE RIVER RD
Second Line :
City : FAIR LAWN
State : NJ
Zip : 07410-5634
Country : US
Telephone Number : 201-796-9225
Fax Number : 201-796-7606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2005
Last Update Date : 09/09/2008

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Directions to “ DR. SALVATORE INFANTINO MD” Practice Location

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