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General NPI Number Information
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NPI Number | 1225144769
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Entity Type | Individual
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Provider Name | ANDREW CHARLES PALERMO DDS
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2 ROMANY WAY
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-5118
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Country | US
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Telephone | 631-368-2882
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Fax | 631-368-0864
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Provider Business Mailing Address
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Address Line | 2 ROMANY WAY
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-5118
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Country | US
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Telephone | 631-368-2882
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Fax | 631-368-0864
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 045141-1
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License Number State | NY
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