Provider Demographics
NPI:1760141972
Name:PALERMO, BIANCA
Entity Type:Individual
Prefix:DR
First Name:BIANCA
Middle Name:
Last Name:PALERMO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 BROOK ST
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-5708
Mailing Address - Country:US
Mailing Address - Phone:914-257-9312
Mailing Address - Fax:
Practice Address - Street 1:203 MAIN ST
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-4750
Practice Address - Country:US
Practice Address - Phone:914-923-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068534183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist