Provider Demographics
NPI:1972568038
Name:SALOMON, LENORE D (PHD, OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:LENORE
Middle Name:D
Last Name:SALOMON
Suffix:
Gender:F
Credentials:PHD, OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-1343
Mailing Address - Country:US
Mailing Address - Phone:203-248-6512
Mailing Address - Fax:
Practice Address - Street 1:245 AMITY RD
Practice Address - Street 2:SUITE 207
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2258
Practice Address - Country:US
Practice Address - Phone:203-389-8177
Practice Address - Fax:203-387-9447
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000310225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT670000006Medicare ID - Type Unspecified