Provider Demographics
NPI:1124355185
Name:SALAMON, ALISA N (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ALISA
Middle Name:N
Last Name:SALAMON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 EASTCHESTER RD
Mailing Address - Street 2:#2E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2105
Mailing Address - Country:US
Mailing Address - Phone:718-701-1053
Mailing Address - Fax:
Practice Address - Street 1:1945 EASTCHESTER RD
Practice Address - Street 2:#2E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2105
Practice Address - Country:US
Practice Address - Phone:718-701-1053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018543235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist