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
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