Provider Demographics
NPI:1366762742
Name:SALERNO, ANNE LENORA (MASTER OF SCIENCE)
Entity type:Individual
Prefix:PROF
First Name:ANNE
Middle Name:LENORA
Last Name:SALERNO
Suffix:
Gender:F
Credentials:MASTER OF SCIENCE
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:LENORA
Other - Last Name:SALERNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:86 STILLWATER AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-8422
Mailing Address - Country:US
Mailing Address - Phone:516-798-6916
Mailing Address - Fax:
Practice Address - Street 1:86 STILLWATER AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-8422
Practice Address - Country:US
Practice Address - Phone:516-798-6916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NY5955174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5955OtherSPECIAL EDUCATION PERMENAT