Provider Demographics
NPI:1134371776
Name:PALERMO, EMMANUEL (RPH)
Entity type:Individual
Prefix:MR
First Name:EMMANUEL
Middle Name:
Last Name:PALERMO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2049 CAESAR PL
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-1868
Mailing Address - Country:US
Mailing Address - Phone:347-582-2571
Mailing Address - Fax:
Practice Address - Street 1:2049 CAESAR PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-1868
Practice Address - Country:US
Practice Address - Phone:347-582-2571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047665183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist