Provider Demographics
NPI:1003933995
Name:PALERMO, GINA ROSE (MS LAT ATC)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:ROSE
Last Name:PALERMO
Suffix:
Gender:F
Credentials:MS LAT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 OLD ANNAPOLIS RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-6920
Mailing Address - Country:US
Mailing Address - Phone:410-313-2871
Mailing Address - Fax:410-313-2870
Practice Address - Street 1:8700 OLD ANNAPOLIS RD
Practice Address - Street 2:SUITE 500
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-6920
Practice Address - Country:US
Practice Address - Phone:410-313-2871
Practice Address - Fax:410-313-2870
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer