Healthcare Provider Details

I. General information

NPI: 1225908957
Provider Name (Legal Business Name): JESSICA PALMACCIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 HUDSON ST
NEW YORK NY
10013-1412
US

IV. Provider business mailing address

43 CYPRESS ST
SWEDESBORO NJ
08085-1258
US

V. Phone/Fax

Practice location:
  • Phone: 332-239-7305
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number358023
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: