Provider Demographics
NPI:1023582251
Name:PALMA, MARGARET J
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:J
Last Name:PALMA
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 1:4545 BUCKINGHAM LN
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-1917
Mailing Address - Country:US
Mailing Address - Phone:716-646-6424
Mailing Address - Fax:
Practice Address - Street 1:1424 LOSSON RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-4615
Practice Address - Country:US
Practice Address - Phone:716-697-9582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351112163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYGD13881DMedicaid