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NPI Code Detail

MEDICARE: DR. ZACHARY JULIAN PALACE MD

MEDICARE: DR. ZACHARY JULIAN PALACE 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
1207RG0300XGeriatric Medicine (Internal Medicine) Physician208688NY

General Provider Information

NPI Number : 1669468740
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ZACHARY JULIAN PALACE MD
Provider Business Mailing Address
First Line : 6 BEDFORD RD
Second Line :
City : WESLEY HILLS
State : NY
Zip : 10952-1301
Country : US
Telephone Number : 718-581-1495
Fax Number : 718-581-1012
Provider Business Practice Location Address
First Line : 5901 PALISADE AVE
Second Line :
City : BRONX
State : NY
Zip : 10471-1205
Country : US
Telephone Number : 718-581-1495
Fax Number : 718-581-1012
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 11/30/2007

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