Provider Demographics
NPI:1609586650
Name:PALOMERA, JOSHUA (MS, RD, LDN, CSN)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:PALOMERA
Suffix:
Gender:M
Credentials:MS, RD, LDN, CSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 SABATTUS ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-6347
Mailing Address - Country:US
Mailing Address - Phone:619-857-6167
Mailing Address - Fax:
Practice Address - Street 1:253 MAIN ST
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6800
Practice Address - Country:US
Practice Address - Phone:207-400-6188
Practice Address - Fax:866-519-6015
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-30
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDI1774133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered