Provider Demographics
NPI:1134158793
Name:PALATT, TERRY (MD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:
Last Name:PALATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14 STEPPING STONE CRES
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5012
Mailing Address - Country:US
Mailing Address - Phone:631-463-7687
Mailing Address - Fax:631-499-8505
Practice Address - Street 1:14 STEPPING STONE CRES
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-5012
Practice Address - Country:US
Practice Address - Phone:631-463-7687
Practice Address - Fax:631-499-8505
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161474208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01091510Medicaid
NY161474OtherLICENSE
NY161474OtherLICENSE