Healthcare Provider Details

I. General information

NPI: 1376582411
Provider Name (Legal Business Name): PHILIP PALMIERI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 06/03/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 NEW SCOTLAND AVE FALK CLINIC SUITE 700
ALBANY NY
12208-2725
US

IV. Provider business mailing address

PO BOX 14890
ALBANY NY
12212-4890
US

V. Phone/Fax

Practice location:
  • Phone: 518-435-0662
  • Fax:
Mailing address:
  • Phone: 518-525-5634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number211401
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: