Healthcare Provider Details

I. General information

NPI: 1043161219
Provider Name (Legal Business Name): CHRISTOPHER PALUMBO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2026
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 ABBOTT RD
BUFFALO NY
14220-2039
US

IV. Provider business mailing address

190 DEXTER TER
TONAWANDA NY
14150-4721
US

V. Phone/Fax

Practice location:
  • Phone: 716-525-6045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number851325
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: