Provider Demographics
NPI:1104860154
Name:PALMER, JOSETTE C (MD)
Entity Type:Individual
Prefix:MS
First Name:JOSETTE
Middle Name:C
Last Name:PALMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:500 GROVE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1761
Mailing Address - Country:US
Mailing Address - Phone:856-796-9255
Mailing Address - Fax:856-796-9397
Practice Address - Street 1:416 SICKLERVILLE RD
Practice Address - Street 2:SUITE A1
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-2556
Practice Address - Country:US
Practice Address - Phone:856-723-8100
Practice Address - Fax:856-723-8107
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA62041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6987605Medicaid
G32609Medicare UPIN
NJ874593C04Medicare PIN