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NPI Code Detail

MEDICARE: DR. NICHOLAS G. PALLADINO MD

MEDICARE: DR. NICHOLAS G. PALLADINO MD
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
1207R00000XInternal Medicine Physician25MA06548800NJ

General Provider Information

NPI Number : 1639116569
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLAS G. PALLADINO MD
Provider Business Mailing Address
First Line : 402 LIPPINCOTT DR
Second Line :
City : MARLTON
State : NJ
Zip : 08053-4112
Country : US
Telephone Number : 856-782-3300
Fax Number : 856-504-8029
Provider Business Practice Location Address
First Line : 485 WILLIAMSTOWN RD
Second Line :
City : SICKLERVILLE
State : NJ
Zip : 08081-1777
Country : US
Telephone Number : 856-227-6575
Fax Number : 856-237-8042
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 05/26/2011

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