Provider Demographics
NPI:1922486331
Name:PALUMBO, GINA
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:PALUMBO
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 1:1224 HIGHLAND TER
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1610
Mailing Address - Country:US
Mailing Address - Phone:716-378-6744
Mailing Address - Fax:
Practice Address - Street 1:1224 HIGHLAND TER
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1610
Practice Address - Country:US
Practice Address - Phone:716-378-6744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist