Healthcare Provider Details

I. General information

NPI: 1881744985
Provider Name (Legal Business Name): ANN MARIE PALAGIANO DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 UNION AVE
IRVINGTON NJ
07111-3262
US

IV. Provider business mailing address

PO BOX 1281
RIDGEWOOD NJ
07451-1281
US

V. Phone/Fax

Practice location:
  • Phone: 973-399-3232
  • Fax: 973-839-3653
Mailing address:
  • Phone: 973-399-3232
  • Fax: 973-839-3653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00247300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: