Provider Demographics
NPI:1255412557
Name:MICHELE R. PALAZZOLO, O.D.
Entity type:Organization
Organization Name:MICHELE R. PALAZZOLO, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:R
Authorized Official - Last Name:PALAZZOLO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:401-463-3500
Mailing Address - Street 1:300 TOLL GATE RD
Mailing Address - Street 2:SUITE 101B
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4416
Mailing Address - Country:US
Mailing Address - Phone:401-463-3500
Mailing Address - Fax:
Practice Address - Street 1:300 TOLL GATE RD
Practice Address - Street 2:SUITE 101B
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4416
Practice Address - Country:US
Practice Address - Phone:401-463-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty