Provider Demographics
NPI:1104277706
Name:SALANITRO, BENEDICT
Entity type:Individual
Prefix:
First Name:BENEDICT
Middle Name:
Last Name:SALANITRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W 45TH ST
Mailing Address - Street 2:STE 301
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4005
Mailing Address - Country:US
Mailing Address - Phone:631-580-5200
Mailing Address - Fax:631-580-5222
Practice Address - Street 1:550 MAMARONECK AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1634
Practice Address - Country:US
Practice Address - Phone:914-777-3737
Practice Address - Fax:914-777-0914
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040736225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist