Healthcare Provider Details

I. General information

NPI: 1033804380
Provider Name (Legal Business Name): DELANEY GRACE PALUMBO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 N WALNUT ST FL 3
HAGERSTOWN MD
21740-4738
US

IV. Provider business mailing address

870 5TH AVE APT 1G
NEW YORK NY
10065-4907
US

V. Phone/Fax

Practice location:
  • Phone: 240-527-2752
  • Fax:
Mailing address:
  • Phone: 212-988-1444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number032559
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: