MEDICARE: SALVO PHYSICIAN PRACTICE PA

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	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1942913173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALVO PHYSICIAN PRACTICE PA

Provider Business Mailing Address
First Line	:	335 MADISON AVE RM 7D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-4687
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 BERRHILL DR
Second Line	:
City	:	WILLIAMSTOWN
State	:	NJ
Zip	:	08094-3669
Country	:	US
Telephone Number	:	917-267-2150
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. MAX PITMAN
Credential	:	MD
Telephone Number	:	917-267-2150

Provider Enumeration Date	:	01/03/2023
Last Update Date	:	01/03/2023

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