Provider Demographics
NPI:1871592923
Name:SALAMON, MARK DAVID (PT)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:DAVID
Last Name:SALAMON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7307
Mailing Address - Country:US
Mailing Address - Phone:610-861-8080
Mailing Address - Fax:610-807-0366
Practice Address - Street 1:2775 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7307
Practice Address - Country:US
Practice Address - Phone:610-861-8080
Practice Address - Fax:610-807-0366
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008970L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0509076OtherAETNA PPO
0810548000OtherAMERIHEALTH
784988OtherFIRST PRIORITY LIFE INS
0810548000OtherKEYSTONE HEALTH EAST
2201266OtherUNITED HEALTHCARE
47241OtherGEISINGER HEALTH PLAN
02121102OtherKEYSTONE HEALTH CENTRAL
0810548000OtherINDEPENDENCE BLUE CROSS
329011OtherHEALTHAMERICA/HEALTHASSUR
2170516OtherMAMSI
P1643785OtherOXFORD HEALTH PLANS
02121102OtherCAPITAL BLUE CROSS
784988OtherHIGHMARK BLUE SHIELD
8032286OtherCIGNA HEALTHCARE
821977OtherFIRST PRIORITY HEALTH
0810548000OtherKEYSTONE HEALTH EAST
PA026659Medicare PIN