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General NPI Number Information
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NPI Number | 1669634499
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Entity Type | Individual
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Provider Name | REMA PALISSERY MENON P.A
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Gender | Female
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 41267 SCARBOROUGH LN
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City | NOVI
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State | MI
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Zip | 48375-2892
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Country | US
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Telephone | 248-987-6252
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Fax |
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Provider Business Mailing Address
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Address Line | 41267 SCARBOROUGH LN
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City | NOVI
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State | MI
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Zip | 48375-2892
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Country | US
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Telephone | 248-987-6252
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5601005227
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License Number State | MI
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