Healthcare Provider Details

I. General information

NPI: 1952693061
Provider Name (Legal Business Name): JEFFREY PALAZZO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2011
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 FALLS OF THE NEUSE RD
RALEIGH NC
27615
US

IV. Provider business mailing address

1509 HERITAGE CLUB AVE
WAKE FOREST NC
27587-7698
US

V. Phone/Fax

Practice location:
  • Phone: 919-845-0613
  • Fax:
Mailing address:
  • Phone: 860-970-9829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19484
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: