Provider Demographics
NPI:1437127248
Name:PALMISANO, ALICIA Z (MED, ATC)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:Z
Last Name:PALMISANO
Suffix:
Gender:F
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3436 TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-3829
Mailing Address - Country:US
Mailing Address - Phone:504-669-0305
Mailing Address - Fax:504-305-3399
Practice Address - Street 1:3436 TEXAS AVE
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-3829
Practice Address - Country:US
Practice Address - Phone:504-669-0305
Practice Address - Fax:504-305-3399
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0021312255A2300X
LAATH.J002712255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer