Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 431141 | NY |
NPI | 1043734718 |
---|---|
Provider Name | Jonathan Salamone |
First Address | Rochester, NY 14617-5504 |
Second Address | Rochester, NY 14621-3001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2017 |
Last Update Date | 24/09/2019 |