Provider Demographics
NPI:1851639280
Name:PALISADES MEDICAL CENTER
Entity Type:Organization
Organization Name:PALISADES MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MEDICAL EDUCATION
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURIZIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGLIETTA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:201-710-2716
Mailing Address - Street 1:3317 BARNES AVE
Mailing Address - Street 2:APT 1A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-6563
Mailing Address - Country:US
Mailing Address - Phone:718-231-3949
Mailing Address - Fax:347-275-6187
Practice Address - Street 1:7600 RIVER RD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-6217
Practice Address - Country:US
Practice Address - Phone:201-710-2716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
1033276290OtherNPI
NY9220E1Medicare PIN