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General NPI Number Information
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NPI Number | 1275278533
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Entity Type | Individual
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Provider Name | SANDRA PALERMO
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Gender | Female
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 05/02/2022
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Provider Practice Location Address
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Address Line | 115 BROADHOLLOW RD STE 10
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City | MELVILLE
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State | NY
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Zip | 11747-4992
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Country | US
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Telephone | 631-990-4352
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Fax |
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Provider Business Mailing Address
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Address Line | 317 BROWNS RD
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City | NESCONSET
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State | NY
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Zip | 11767-3343
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Country | US
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Telephone | 631-457-3040
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 031393
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License Number State | NY
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