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NPI 1689263816

NPI 1689263816 : ROBERT M PALMA JR. PT, DPT : GREAT NECK, NY

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General NPI Number Information
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    NPI Number           |    1689263816
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT M PALMA JR. PT, DPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/12/2021
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    Last Update Date     |    03/01/2023
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Provider Practice Location Address
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    Address Line         |    475 NORTHERN BLVD STE 11 
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    City                 |    GREAT NECK
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    State                |    NY
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    Zip                  |    11021-4802
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    Country              |    US
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    Telephone            |    516-829-0030
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    307 5TH AVE FL 6 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10016-6575
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    Country              |    US
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    Telephone            |    212-759-2282
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    Fax                  |    212-379-2123
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    046519-01
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    License Number State |    NY
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