Healthcare Provider Details

I. General information

NPI: 1598242224
Provider Name (Legal Business Name): RICHARD PALOMINO PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2018
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BUILDING 1 CASERMA DEL DIN
VICENZA ITALY
36100
IT

IV. Provider business mailing address

BUILDING 1 CASERMA DEL DIN
VICENZA ITALY
36100
IT

V. Phone/Fax

Practice location:
  • Phone: 16-254-3332
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: