Healthcare Provider Details

I. General information

NPI: 1336280007
Provider Name (Legal Business Name): NEIL A PALKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 SCENIC DR
BERLIN CT
06037-2522
US

IV. Provider business mailing address

63 SCENIC DR
BERLIN CT
06037-2522
US

V. Phone/Fax

Practice location:
  • Phone: 860-759-2801
  • Fax: 860-812-2102
Mailing address:
  • Phone: 860-759-2801
  • Fax: 860-812-2102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number017519
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: