Healthcare Provider Details

I. General information

NPI: 1285661868
Provider Name (Legal Business Name): VINCENT J PALUSCI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 01/18/2025
Certification Date: 01/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 1ST AVE
NEW YORK NY
10016-9196
US

IV. Provider business mailing address

160 E 38TH ST APT 9D
NEW YORK NY
10016-2609
US

V. Phone/Fax

Practice location:
  • Phone: 125-626-0732
  • Fax:
Mailing address:
  • Phone: 212-697-0802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080C0008X
TaxonomyChild Abuse Pediatrics Physician
License Number163299
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number163299
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: