Basic Information
| Provider Information | |||||||||
| NPI: | 1114002441 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | INSERRA | ||||||||
| FirstName: | SALVATORE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 45 RESEARCH WAY | ||||||||
| Address2: | STE 105 | ||||||||
| City: | EAST SETAUKET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117336401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316752125 | ||||||||
| FaxNumber: | 6316752624 | ||||||||
| Practice Location | |||||||||
| Address1: | 309 MIDDLE COUNTRY RD | ||||||||
| Address2: | STE 101 | ||||||||
| City: | SMITHTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11787 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6313602200 | ||||||||
| FaxNumber: | 6313601328 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2006 | ||||||||
| LastUpdateDate: | 06/30/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 145138-1 | NY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0919077 | 01 | NY | CIGNA | OTHER | 4288391 | 01 | NY | AETNA | OTHER | 0069854 | 01 | NY | GHI | OTHER | 14D891 | 01 | NY | BLUE CROSS BLUE SHEILD | OTHER | 488345 | 01 | NY | UNITEDHEALTHCARE | OTHER | 00821572 | 05 | NY | MEDICAID | 200008348 | 01 | NY | RAILROAD MEDICARE | OTHER | 2C1476 | 01 | NY | HEALTHNET | OTHER | W21941 | 01 | NY | MEDICARE GROUP PTAN | OTHER | CS142 | 01 | NY | OXFORD | OTHER | 14D891 | 01 | NY | BC/BS | OTHER |