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General NPI Number Information
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NPI Number | 1386187789
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Entity Type | Individual
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Provider Name | SALVATORE MICHAEL PALERMO DAT, LAT, ATC, CES
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Gender | Male
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Dates
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Enumeration Date | 12/02/2016
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 300 AVENGER DR
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City | EAST GREENWICH
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State | RI
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Zip | 02818-2217
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Country | US
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Telephone | 401-481-5035
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Fax |
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Provider Business Mailing Address
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Address Line | 14 CHARTER ST
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City | JOHNSTON
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State | RI
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Zip | 02919-5077
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Country | US
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Telephone | 401-481-5035
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 3020
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT00458
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License Number State | RI
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