Individual
MRS. THERESA MARGARET SALAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1500 ROUTE 112 BLDG 11, SUITES A-B, PORT JEFFERSON STATION, NY 11776-3184
(631) 474-4917
Mailing address
1500 ROUTE 112 BLDG 11, SUITES A-B, PORT JEFFERSON STATION, NY 11776-3184
(631) 474-4917
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
F 420645-1
NY
Other
Enumeration date
04/03/2013
Last updated
04/03/2013
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