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NPI Code Detail

MEDICARE: MRS. TERESA MARIE PALMISANO OT

MEDICARE: MRS. TERESA MARIE PALMISANO OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist2692-26WI

General Provider Information

NPI Number : 1073822458
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TERESA MARIE PALMISANO OT
Provider Business Mailing Address
First Line : 322 W COLLEGE AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53207-6224
Country : US
Telephone Number : 414-839-9129
Fax Number :
Provider Business Practice Location Address
First Line : 9806 W LINCOLN AVE
Second Line :
City : WEST ALLIS
State : WI
Zip : 53227-2234
Country : US
Telephone Number : 414-543-5330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2010
Last Update Date : 10/01/2010

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