Basic Information
| Provider Information | |||||||||
| NPI: | 1043364631 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SALVATORE | ||||||||
| FirstName: | MIRELLA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 525 EAST 69TH STREET BOX 125 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127466320 | ||||||||
| FaxNumber: | 2127468675 | ||||||||
| Practice Location | |||||||||
| Address1: | 1900 SECOND AVENUE 9TH FLOOR | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123607893 | ||||||||
| FaxNumber: | 2123487253 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2007 | ||||||||
| LastUpdateDate: | 01/24/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 233172 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.