Organization
SUSAN L. SALAK, D.P.M., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN L. SALAK, D.P.M., P.C. D.P.M. (PODIATRIST)
(570) 823-0187
Entity
Organization
Contact information
Practice address
34 S MAIN ST, SUITE 9, WILKES BARRE, PA 18701-1723
(570) 823-0187
(570) 823-0188
Mailing address
34 S MAIN ST, SUITE 9, WILKES BARRE, PA 18701-1723
(570) 823-0187
(570) 823-0188
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC003648L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014528270005
—
PA
01
—
803141
HMO
PA
01
—
SA1626367
BLUE SHIELD
PA
Enumeration date
10/23/2006
Last updated
01/31/2008
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