Healthcare Provider Details

I. General information

NPI: 1265646301
Provider Name (Legal Business Name): JOHN P PALMERI CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/05/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 WESTFALL RD STE 300 BRIGHTON SURGICAL CENTER
ROCHESTER NY
14618
US

IV. Provider business mailing address

980 WESTFALL ROAD STE 350
ROCHESTER NY
14618-2609
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-5982
  • Fax: 585-756-0169
Mailing address:
  • Phone: 585-271-4280
  • Fax: 585-271-4311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number5213511
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number521351
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: