Healthcare Provider Details

I. General information

NPI: 1104860154
Provider Name (Legal Business Name): JOSETTE C PALMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 12/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 SICKLERVILLE RD SUITE A1
SICKLERVILLE NJ
08081-2556
US

IV. Provider business mailing address

500 GROVE ST SUITE 100
HADDON HEIGHTS NJ
08035-1761
US

V. Phone/Fax

Practice location:
  • Phone: 856-723-8100
  • Fax: 856-723-8107
Mailing address:
  • Phone: 856-796-9255
  • Fax: 856-796-9397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA62041
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: