Healthcare Provider Details

I. General information

NPI: 1821534561
Provider Name (Legal Business Name): LENORE PALLADINO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2017
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 N PEARL ST # M
MENANDS NY
12204-1659
US

IV. Provider business mailing address

570 N PEARL ST
MENANDS NY
12204-1659
US

V. Phone/Fax

Practice location:
  • Phone: 518-475-6805
  • Fax: 518-475-6802
Mailing address:
  • Phone: 518-475-6805
  • Fax: 518-475-6802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number360918
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: