Provider Demographics
NPI:1467752931
Name:PALERMO, JOAN
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:PALERMO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 E 97TH ST
Mailing Address - Street 2:APT. 4B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6922
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 E 97TH ST
Practice Address - Street 2:APT. 4B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6922
Practice Address - Country:US
Practice Address - Phone:212-348-4739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY926781001OtherMEDICARE COMPLETE