Healthcare Provider Details

I. General information

NPI: 1881769115
Provider Name (Legal Business Name): RONALD JOHN PALMIERI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 HADDON AVE
WESTMONT NJ
08108-2817
US

IV. Provider business mailing address

212 HADDON AVE
WESTMONT NJ
08108-2817
US

V. Phone/Fax

Practice location:
  • Phone: 856-869-4934
  • Fax:
Mailing address:
  • Phone: 856-869-4934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMA2503111200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: