Provider Demographics
NPI:1003088386
Name:STEPHEN S PALAZZOLO
Entity Type:Organization
Organization Name:STEPHEN S PALAZZOLO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:PALAZZOLO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:775-882-3937
Mailing Address - Street 1:844 W NYE LN STE 104
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-1571
Mailing Address - Country:US
Mailing Address - Phone:775-882-3937
Mailing Address - Fax:775-882-4006
Practice Address - Street 1:844 W NYE LN STE 104
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-1571
Practice Address - Country:US
Practice Address - Phone:775-882-3937
Practice Address - Fax:775-882-4006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies