Provider Demographics
NPI:1215059589
Name:SALKIN, WILROCHELLE BERNALES (PT)
Entity type:Individual
Prefix:
First Name:WILROCHELLE
Middle Name:BERNALES
Last Name:SALKIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:WILROCHELLE
Other - Middle Name:BOLIGOR
Other - Last Name:BERNALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:131 E 104TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-4921
Mailing Address - Country:US
Mailing Address - Phone:212-860-5831
Mailing Address - Fax:212-860-8844
Practice Address - Street 1:131 E 104TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-4921
Practice Address - Country:US
Practice Address - Phone:212-860-5831
Practice Address - Fax:212-860-8844
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2012-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00994100225100000X
IN05006074A225100000X
GU000040225100000X
NY0211932251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist