Provider Demographics
NPI:1902682776
Name:SALAMONE, VICTORIA ISABELLA
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ISABELLA
Last Name:SALAMONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-6830
Mailing Address - Country:US
Mailing Address - Phone:718-704-4376
Mailing Address - Fax:
Practice Address - Street 1:200 N VILLAGE AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2341
Practice Address - Country:US
Practice Address - Phone:718-704-4376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist