Provider Demographics
NPI:1538327622
Name:PALLANDINO, MERCEDES LEANDER (LPN)
Entity Type:Individual
Prefix:MS
First Name:MERCEDES
Middle Name:LEANDER
Last Name:PALLANDINO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35309 JACKSON II RD
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NY
Mailing Address - Zip Code:13619-8521
Mailing Address - Country:US
Mailing Address - Phone:315-493-1281
Mailing Address - Fax:
Practice Address - Street 1:35309 JACKSON II RD
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NY
Practice Address - Zip Code:13619-8521
Practice Address - Country:US
Practice Address - Phone:315-493-1281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274454164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02585555Medicaid