Healthcare Provider Details

I. General information

NPI: 1013152552
Provider Name (Legal Business Name): JOSEPH DAVID PALKO OTR/L, ABDA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2008
Last Update Date: 12/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 N KEYSER AVE
SCRANTON PA
18504-9728
US

IV. Provider business mailing address

561 CHESTNUT ST
DUNMORE PA
18512-2930
US

V. Phone/Fax

Practice location:
  • Phone: 570-343-7663
  • Fax: 570-343-7664
Mailing address:
  • Phone: 570-498-0926
  • Fax: 570-343-7664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOC-003261-L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: