Elba L Salamanca Rivera

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

299 Hallock Ave
Port Jefferson Station, NY 11776-1217

Phone

(631) 215-3337

NPI assigned

Jul 31, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1619706348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CAMPO AVE",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117841704",
            "telephone_number": "631-855-8299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 HALLOCK AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761217",
            "telephone_number": "631-215-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAMANCA RIVERA",
        "first_name": "ELBA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "NY",
            "license": "429109",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonino Russo, DDS
• Shannon Russo
• Patrick James Sabo, D.M.D.
• Tammy Said
• Patty Sainval
• Theresa Margaret Salas, NP
• Brian Saltzer
• Jennifer M Samghabadi, NP
• Ashley Samonte
• Emily Samuels

• Early Intervention Provider Agency in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.