Provider Demographics
NPI:1801208327
Name:SALERNO, TERESA L (MPAS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:L
Last Name:SALERNO
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5523 BEEJAY CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-2902
Mailing Address - Country:US
Mailing Address - Phone:937-890-7202
Mailing Address - Fax:
Practice Address - Street 1:1150 W DOROTHY LN
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-1305
Practice Address - Country:US
Practice Address - Phone:937-885-7163
Practice Address - Fax:513-275-3262
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH003960363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant