Provider Demographics
NPI:1205640927
Name:SALAZAR CUEVA, CARLA ALEXANDRA
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:ALEXANDRA
Last Name:SALAZAR CUEVA
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 1:15 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-5813
Mailing Address - Country:US
Mailing Address - Phone:631-575-9170
Mailing Address - Fax:
Practice Address - Street 1:6545 FRESH MEADOW LN
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11365-2011
Practice Address - Country:US
Practice Address - Phone:718-267-5441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator