Healthcare Provider Details

I. General information

NPI: 1225471857
Provider Name (Legal Business Name): MICHAEL EDWARD PALMA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2013
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HEALTHY WAY
OCEANSIDE NY
11572-1551
US

IV. Provider business mailing address

68 S SERVICE RD STE 350
MELVILLE NY
11747-2358
US

V. Phone/Fax

Practice location:
  • Phone: 877-768-8462
  • Fax:
Mailing address:
  • Phone: 516-945-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number288508
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: