Provider Demographics
NPI:1710766993
Name:PALOMBO, GEORGE A
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:A
Last Name:PALOMBO
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 1:373 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:15074-1623
Mailing Address - Country:US
Mailing Address - Phone:724-775-7905
Mailing Address - Fax:
Practice Address - Street 1:373 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:PA
Practice Address - Zip Code:15074-1623
Practice Address - Country:US
Practice Address - Phone:724-775-7905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)