Provider Demographics
NPI:1558672568
Name:PALUMBO, KATHRYN (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:PALUMBO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3959 BROADWAY # CHN10-24
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1559
Mailing Address - Country:US
Mailing Address - Phone:212-305-8458
Mailing Address - Fax:212-342-2293
Practice Address - Street 1:3959 BROADWAY # CHN10-24
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1559
Practice Address - Country:US
Practice Address - Phone:212-305-8458
Practice Address - Fax:212-342-2293
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273918207LP3000X
RILP02084207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine