Healthcare Provider Details

I. General information

NPI: 1134158793
Provider Name (Legal Business Name): TERRY PALATT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/26/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 STEPPING STONE CRES
DIX HILLS NY
11746-5012
US

IV. Provider business mailing address

14 STEPPING STONE CRES
DIX HILLS NY
11746-5012
US

V. Phone/Fax

Practice location:
  • Phone: 631-463-7687
  • Fax: 631-499-8505
Mailing address:
  • Phone: 631-463-7687
  • Fax: 631-499-8505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number161474
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: