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Organization

PEDIATRIC HEMATOLOGY/ONCOLOGY SPECIALISTS

Active
Parent organization
PEDIATRIC HEMATOLOGY/ONCOLOGY SPECIALISTS
Organization subpart
Yes

Provider details

NPI number
Legal business name
PEDIATRIC HEMATOLOGY/ONCOLOGY SPECIALISTS
Authorized official
DR. SALVATORE JAMES BERTOLONE JR. MD (PRESIDENT)
(502) 629-7750
Entity
Organization

Contact information

Practice address
601 S FLOYD ST, SUITE 403, LOUISVILLE, KY 40202-1835
(502) 629-7750
(502) 629-7784
Mailing address
601 S FLOYD ST, SUITE 403, LOUISVILLE, KY 40202-1835
(502) 629-7750
(502) 629-7784

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
KY
363LP0200X
Pediatric Nurse Practitioner
Primary
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
78905171
KY
Enumeration date
01/24/2008
Last updated
01/24/2008
Update your record

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