Provider Demographics
NPI:1538677372
Name:PALMIERE, THOMAS ANGELO
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:ANGELO
Last Name:PALMIERE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 LIVINGSTON ST FL 1
Mailing Address - Street 2:
Mailing Address - City:NORTHVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07647-1835
Mailing Address - Country:US
Mailing Address - Phone:201-410-4787
Mailing Address - Fax:
Practice Address - Street 1:1415 QUEEN ANNE RD STE 100
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3521
Practice Address - Country:US
Practice Address - Phone:201-837-9993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-15
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJTR00363600225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics