Provider Demographics
NPI:1578759403
Name:PALMER, ADAM E (LAC)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:E
Last Name:PALMER
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 COURT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-4032
Mailing Address - Country:US
Mailing Address - Phone:646-750-2185
Mailing Address - Fax:718-254-7004
Practice Address - Street 1:476 COURT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-4032
Practice Address - Country:US
Practice Address - Phone:646-750-2185
Practice Address - Fax:718-254-7004
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002103171100000X
NY0002103171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist