Provider Demographics
NPI:1639194731
Name:PALMER, RONALD IRWIN (MA)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:IRWIN
Last Name:PALMER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:148-670-7950
Mailing Address - Fax:814-670-7951
Practice Address - Street 1:811 GRANDVIEW RD STE 100
Practice Address - Street 2:
Practice Address - City:OIL CITY
Practice Address - State:PA
Practice Address - Zip Code:16301-2077
Practice Address - Country:US
Practice Address - Phone:814-670-7950
Practice Address - Fax:814-670-7951
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005854L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA209105OtherUPMC
PA201297000OtherMAGELLAN
PA003763OtherVALUE OPTIONS
PA263728OtherBLUE SHIELD
PA716744OtherBLUE SHIELD