Individual
JORGE V SALAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 HORSEPOUND RD, CARMEL, NY 10512-5008
(845) 612-9683
Mailing address
111 HORSEPOUND RD, CARMEL, NY 10512-5008
(845) 612-9683
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PBCH1965
VMS
NY
Enumeration date
05/22/2018
Last updated
05/22/2018
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