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General NPI Number Information
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NPI Number | 1083858682
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Entity Type | Individual
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Provider Name | DR. PATRICIA EILLEN PALOS
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Gender | Female
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Dates
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Enumeration Date | 04/27/2009
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Last Update Date | 08/31/2015
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Provider Practice Location Address
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Address Line | 2 1/2 DEARFIELD DR SUITE 101
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City | GREENWICH
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State | CT
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Zip | 06831-5335
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Country | US
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Telephone | 203-861-9586
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Fax | 203-861-9587
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Provider Business Mailing Address
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Address Line | 2 1/2 DEARFIELD DR SUITE 101
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City | GREENWICH
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State | CT
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Zip | 06831-5335
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Country | US
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Telephone | 203-861-9586
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Fax | 203-861-9587
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 69687
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 054416
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License Number State | CT
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