MEDICARE: THERESA SALERNO FNP-BC, RN

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	363LF0000X	Family Nurse Practitioner	337179	NY

General Provider Information

NPI Number	:	1831445931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA SALERNO FNP-BC, RN

Provider Business Mailing Address
First Line	:	101 CHARLES ST
Second Line	:	5RE
City	:	NEW YORK
State	:	NY
Zip	:	10014
Country	:	US
Telephone Number	:	732-939-3210
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 CHARLES ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10014-6122
Country	:	US
Telephone Number	:	732-939-3210
Fax Number	:

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

Provider Enumeration Date	:	07/26/2012
Last Update Date	:	07/21/2022

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