Provider Demographics
NPI:1861511818
Name:PHILIP M. PALMERI, DPM, PC
Entity Type:Organization
Organization Name:PHILIP M. PALMERI, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:M
Authorized Official - Last Name:PALMERI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-352-4454
Mailing Address - Street 1:925 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-3636
Mailing Address - Country:US
Mailing Address - Phone:516-352-4454
Mailing Address - Fax:516-326-9605
Practice Address - Street 1:925 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 110
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-3641
Practice Address - Country:US
Practice Address - Phone:516-352-4454
Practice Address - Fax:516-326-9605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003784213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT51300Medicare UPIN
PHW201Medicare PIN