Provider Demographics
NPI:1053478214
Name:PALMERI, YOVANI (PA)
Entity Type:Individual
Prefix:
First Name:YOVANI
Middle Name:
Last Name:PALMERI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 1ST AVE
Mailing Address - Street 2:SUITE 10 SOUTH 1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9196
Mailing Address - Country:US
Mailing Address - Phone:212-562-2227
Mailing Address - Fax:212-562-2991
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:SUITE 10 SOUTH 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-2227
Practice Address - Fax:212-562-2991
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011684363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00403310OtherRAILROAD
NYP00403310OtherRAILROAD
NYQ75090Medicare UPIN