Healthcare Provider Details

I. General information

NPI: 1629544309
Provider Name (Legal Business Name): WHITE PLAINS PHYSICIAN MEDICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2018
Last Update Date: 10/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 E POST RD
WHITE PLAINS NY
10601-4607
US

IV. Provider business mailing address

41 E POST RD
WHITE PLAINS NY
10601-4607
US

V. Phone/Fax

Practice location:
  • Phone: 914-681-1210
  • Fax: 914-681-2839
Mailing address:
  • Phone: 914-681-1210
  • Fax: 914-681-2839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0205X
TaxonomyRadiological Physics Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2085H0002X
TaxonomyHospice and Palliative Medicine (Radiology) Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL J PALUMBO
Title or Position: CMO/SVP
Credential: MD
Phone: 914-681-1210