Healthcare Provider Details

I. General information

NPI: 1518308287
Provider Name (Legal Business Name): PALMER MEDICAL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 W 20TH ST SECOND FLOOR
NEW YORK NY
10011-4213
US

IV. Provider business mailing address

20 W 20TH ST SECOND FLOOR
NEW YORK NY
10011-4213
US

V. Phone/Fax

Practice location:
  • Phone: 212-457-0094
  • Fax: 212-457-0093
Mailing address:
  • Phone: 212-457-0094
  • Fax: 212-457-0093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: TAMMY CARPENTER
Title or Position: OFFICE MANAGER
Credential:
Phone: 212-457-0094