Healthcare Provider Details

I. General information

NPI: 1669235743
Provider Name (Legal Business Name): DEBRA A PALMER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 MAIN ST
FARMINGDALE NJ
07727-1340
US

IV. Provider business mailing address

271 GROVE AVE STE E
VERONA NJ
07044-1730
US

V. Phone/Fax

Practice location:
  • Phone: 732-938-6471
  • Fax: 833-488-1209
Mailing address:
  • Phone: 973-559-3700
  • Fax: 833-484-1686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00810400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: