MEDICARE: ROGER E SALISBURY 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
1	2086S0122X	Plastic and Reconstructive Surgery Physician	1472541	NY

General Provider Information

NPI Number	:	1932165008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROGER E SALISBURY MD

Provider Business Mailing Address
First Line	:	45 EASTERN POINT RD
Second Line	:
City	:	GLOUCESTER
State	:	MA
Zip	:	01930-4139
Country	:	US
Telephone Number	:	914-438-1752
Fax Number	:	978-282-0977

Provider Business Practice Location Address
First Line	:	45 EASTERN POINT RD
Second Line	:
City	:	GLOUCESTER
State	:	MA
Zip	:	01930-4139
Country	:	US
Telephone Number	:	914-438-1752
Fax Number	:	978-282-0977

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	04/22/2014

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