Provider Demographics
NPI:1821186560
Name:PALOMATA, MARIA THERESA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:THERESA
Last Name:PALOMATA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2091 KLOCKNER RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3416
Mailing Address - Country:US
Mailing Address - Phone:609-981-7160
Mailing Address - Fax:
Practice Address - Street 1:2091 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3416
Practice Address - Country:US
Practice Address - Phone:609-890-9191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07637200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0195898Medicaid
NJ0195898Medicaid
NJ076212M5NMedicare PIN