Healthcare Provider Details

I. General information

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

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 VERONICA AVE
SOMERSET NJ
08873-3529
US

IV. Provider business mailing address

84 VERONICA AVE
SOMERSET NJ
08873-3529
US

V. Phone/Fax

Practice location:
  • Phone: 732-379-3128
  • Fax: 732-419-5799
Mailing address:
  • Phone: 732-379-3128
  • Fax: 732-419-5799

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: