Provider Demographics
NPI:1497940431
Name:NICHOLAS J. PALERMO DO, PC
Entity Type:Organization
Organization Name:NICHOLAS J. PALERMO DO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PALERMO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:860-645-3927
Mailing Address - Street 1:49 ERIE ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040
Mailing Address - Country:US
Mailing Address - Phone:860-645-3927
Mailing Address - Fax:860-643-2531
Practice Address - Street 1:257 EAST CENTER STREET
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040
Practice Address - Country:US
Practice Address - Phone:860-645-3927
Practice Address - Fax:860-643-2531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty