Provider Demographics
NPI:1275615379
Name:JOHN A. PALUMBO,MD & ASSOC,P.C.
Entity Type:Organization
Organization Name:JOHN A. PALUMBO,MD & ASSOC,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PALUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-295-3012
Mailing Address - Street 1:1525 OREGON PIKE
Mailing Address - Street 2:DR JOHN A PALUMBO MD, SUITE 1201
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601
Mailing Address - Country:US
Mailing Address - Phone:717-295-2012
Mailing Address - Fax:717-295-3014
Practice Address - Street 1:1525 OREGON PIKE
Practice Address - Street 2:SUITE 1201
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4372
Practice Address - Country:US
Practice Address - Phone:717-295-2012
Practice Address - Fax:717-295-3014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032838L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1508967902OtherPALMETTO
PA1508967902OtherPALMETTO
PA179662Medicare PIN